Pharmacological anti-inflammatory treatment in children and adolescents with depressive symptoms: A systematic-review and meta-analysis

Eur Neuropsychopharmacol. 2024 Jan:78:16-29. doi: 10.1016/j.euroneuro.2023.09.006. Epub 2023 Oct 19.


Growing evidence suggests an association between inflammatory processes and depressive disorders (DD). DD typically emerge during adolescence. Treatment effects of agents with anti-inflammatory properties in youth DD have not been systematically reviewed. Here, the existing evidence on the use of anti-inflammatory drugs (including polyunsaturated fatty acids, nonsteroidal anti-inflammatory drugs, cytokine inhibitors, statins, pioglitazone, corticosteroids, and minocycline or modafinil) in children and adolescents with DD was synthesized using meta-analysis. The PROSPERO preregistered search yielded 22 records meeting search criteria. Of these, data from 19 primary studies (n = 1366 subjects) were subjected to meta-analysis. A significant but small effect in favor of anti-inflammatory agents in reducing depressive symptoms in youth with DD was found (SMD = -0.29, 95 % CI = -0.514; -0.063, p = 0.01). Post-hoc analyzes of drug subclasses found a significant effect of omega-3 fatty acids in reducing depressive symptoms. Results underline the importance to consider inflammatory pathways in the supplemental treatment of youth with DD. Further research is warranted, to clarify if anti-inflammatory agents are only effective in a subpopulation of patients (inflammatory biotype of depression in youth) and/or to alleviate specific symptom domains of depression (e.g., cognitive symptoms).

Keywords: Adolescents; Anti-inflammatory treatment; Children; Depression; Inflammation.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use
  • Child
  • Depression* / drug therapy
  • Fatty Acids, Omega-3*
  • Humans
  • Minocycline
  • Pioglitazone


  • Anti-Inflammatory Agents
  • Minocycline
  • Pioglitazone
  • Fatty Acids, Omega-3