Role of Minocycline as an Adjunct Neuroinflammatory Modulator in Treatment-Resistant Depression: A Systematic Review of Randomized Controlled Trials.

Objective: To assess the efficacy and safety evidence for adjunct minocycline in treatment-resistant depression (TRD).Data Sources: In this systematic review, PubMed, PubMed Central, Embase, and Google Scholar were searched from inception to October 2022. The following keywords were utilized in the search: "depression" AND "minocycline" AND "treatment, pharmacological intervention, management." Medical Subject Heading terms for "minocycline" and "depression, depressive disorder, treatment-resistant," and "disease management" were also used. Relevant peer-reviewed, English-language articles that included adults and children were selected for final evaluation.Study Selection: Two authors independently searched and selected 1,004 relevant articles. Only randomized controlled trials were considered. Five articles were identified that fulfilled the inclusion criteria.Data Extraction: The PICO algorithm (Population, Intervention, Comparison, Outcomes, and Study Design) framework was utilized, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria guidelines were followed. The Cochrane risk of bias tool was used to categorize the included study as a low, unclear, or high risk of bias.Results: Minocycline as an adjunct immunomodulator shows inconsistent benefit in TRD. Minocycline has some beneficial effect on depression scale scores and inflammatory markers in TRD patients with inflammatory disequilibrium (C-reactive protein elevation exceeds 3 mg/L). However, minocycline showed an inconclusive effect in TRD with no clear immunologic dysregulation. Minocycline might have a neuroprotective, rather than therapeutic, effect at a small dose.Conclusions: The results were inconsistent regarding the clinical and neuroprotective role of minocycline in TRD. More study is needed to clarify the pathophysiologic and clinical role of minocycline as an immunomodulator in TRD.Prim Care Companion CNS Disord 2023;25(5):22r03467. Author affiliations are listed at the end of this article.

Suicide Risk Among Adolescents With ADHD: An Overview From the National Inpatient Sample Data Set.

ABSTRACT: Studies have shown an association between attention deficit hyperactivity disorder (ADHD) and suicide; however, it has not been studied from inpatient hospitalization data among adolescents. For this study, data from the National Inpatient Sample data set were used. Based on the diagnosis of ADHD, the patient sample was stratified into two groups. Study group was composed of patients with ADHD, and control group was selected by propensity score matching (1:1), which composed of patients without ADHD. The primary outcome was suicidal ideation/attempt between the groups. Prevalence of SI was 25.1% in patients with ADHD versus 10.3% among patients without ADHD. Prevalence of SA was also very high (8.0% vs 3.9%) among patient with ADHD compared with non-ADHD group. After controlling for covariates, ADHD was a strong predictor of suicidal ideation/attempt with an odds ratio of 2.18. It is important to screen for suicidality in patient with ADHD given the high prevalence of suicidality.

The Association of Psychological Stressors With Cannabis Use During Pregnancy: Findings From the National Survey on Drug Use and Health 2017-2019.

ABSTRACT: Even though marijuana is illegal on the federal level, it is one of the most used drugs in the United States during pregnancy. Our study investigates the relationship between numerous socioeconomic, demographic, and mental health risk variables and substance use during pregnancy. We examined data from the National Survey on Drug Use and Health from 2017 to 2019. Compared with the no serious psychological distress (SPD) group, the odds of using cannabis were higher in pregnant women with past-month SPD. In this study, in comparison with unmarried pregnant women, married pregnant women had a 67% lower chance of currently using cannabis. Racially, Hispanic pregnant women had 3 to 4 times higher odds for current use of cannabis as compared with the other races. Preventing cannabis use and its adverse effects by screening pregnant women could be part of the current strategy for reducing cannabis use.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients.

This is the first study that explored the self-reported dietary habits of acute psychiatric inpatients. We found that 75% of the psychiatric inpatients have an unhealthy diet, which correlates with higher body mass index (BMI) and lower education level. We also found an increased sugar consumption in inpatients with schizophrenia. The link between nutrition and mental health has been explored to a limited extent owing to the cumbersome nature of conducting research that involves specific dietary intervention and follow up. Yet, there is existing literature linking poor diet with impaired mental health and poor recovery from depression, amongst other disorders. Good nutrition can be exemplified with diets like the Mediterranean diet with a focus on certain food groups that provide the nutrients linked to neurotransmitters and a fairly new concept of the gut-brain axis. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression. A randomised controlled trial published in the nutritional neuroscience journal yielded a positive outcome and improvement in the overall well-being of the patients enrolled. We explored the dietary habits of acute inpatients. After gathering a detailed diet history, their food habits were compared to a Mediterranean dietary index to assess their dietary patterns. Additionally, variables such as socio-economic characteristics, physical activity, income, BMI, and educational achievement were taken into consideration, with the intention to understand the effect of these factors on a diet consumed by acute patients and the relationship of the diet with their mental wellbeing. Ultimately, this study aims at an important aspect of preventive mental health, i.e., improved dietary habits (e.g., Mediterranean diet) may contribute to more rapid symptoms resolution and acute stabilization on a short-stay inpatient unit.