Minocycline and Celecoxib as Adjunctive Treatments of Bipolar Depression

Inclusion Criteria:

• Patients aged 18-65 years;

• Diagnostic and Statistical Manual-5 (DSM 5) diagnosis of bipolar I or II disorder andcurrent major depressive disorder;

• Experiencing current depressive symptoms for at least 4 weeks (HAMD-17 score ≥18);

• Competent and willing to give informed consent;

• Taking the current medication for a minimum of 4 week prior to baseline;

• Able to take oral medication;

• If female, willing to use adequate contraceptive precautions and to have monthlypregnancy tests.

Exclusion Criteria:

• Relevant medical illness (HIV, renal, hepatic, cardiac, serious dermatologicaldisorders such as exfoliative dermatitis, systemic lupus erythematosis);

• Prior history of intolerance to any of the tetracyclines or NSAIDs;

• Concomitant penicillin therapy;

• Concomitant anticoagulant therapy;

• Presence of a seizure disorder;

• Currently taking other antibiotics, other NSAIDs, acetazolamide, or methotrexate;

• Any change of psychotropic medications within the previous 4 weeks;

• Diagnosis of substance abuse (except nicotine or caffeine) or dependence within thelast 3 months according to DSM-5 criteria;

• Pregnant or breast-feeding;

• Presence of primary psychotic disorder;

• Serious risk of suicide;

• Current three or more manic/hypomanic symptoms.