Another Arrow in our Quiver: a Role for Anti-Inflammatory Therapies in Mental Health Treatment for Pediatric Patients

Abstract

The prevalence of pediatric depression and anxiety has surged dramatically, particularly in the wake of the COVID-19 pandemic, exposing limitations in existing mental health treatments. Traditional therapies of psychotropics and psychotherapies often yield suboptimal results due to limited efficacy, tolerability concerns, poor adherence, and treatment resistance. Emerging evidence suggests neuroinflammation may drive treatment-resistant psychiatric symptoms in youth, particularly in cases of sudden-onset symptoms and post-infectious presentations. In this select group of patients, anti-inflammatory therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antihistamines, corticosteroids, and intravenous immunoglobulin (IVIG), show promise as adjunctive and/or alternative interventions, potentially providing symptom relief and improved tolerability compared with psychotropics. Though behavioral therapy and psychotropics like selective serotonin reuptake inhibitors (SSRIs) remain a mainstay of treatment, anti-inflammatory therapies represent a promising “arrow in the quiver,” especially in cases where antidepressants are insufficient or contraindicated; NSAIDs in particular may provide safe and rapid symptom relief. Further research is needed to establish treatment protocols and guide clinicians in providing personalized care for neuroimmune-linked psychiatric disorders in youth; however, we aim to help fuel this important conversation and encourage clinicians to begin considering anti-inflammatory therapies as part of their clinical toolkit.