Measuring the Effects of Treatment

significant antidepressant treatment effect. Nonsteroidalanti-inflammatory drugs (NSAIDs), in particular the selec-tive cyclooxygenase-2 (COX-2) inhibitor celecoxib, showedadjunctive antidepressant effects, whereas results on cyto-kine inhibitors did not alone reach significance. Thus, theclinical potential of the conducted trials and their resultssupport a proof of concept of anti-inflammatory interven-tion in depression.However, we emphasized the high heterogeneity andhigh risk for bias throughout the included studies and thatfuture trials should increase focus on adverse events. As dis-cussed in our article, it is important to balance potentialtreatment effects vs adverse events, in particular concerningthe selective COX-2 inhibitors, owing to risks for cardiovas-cular adverse effects. In their letter, Anglin et al furthermoreemphasized this important aspect because concomitant useof selective serotonin reuptake inhibitors and NSAIDsincreases the risk for gastrointestinal bleeding. Nevertheless,it appears that early anti-inflammatory intervention usedduring acute phases with duration of 8 to 12 weeks amongnewly diagnosed patients improves treatment effects of anti-depressant medication. These effects might be augmentedby tailored treatment based on immune profiling of thepatient,