J Affect Disord. 2024 Aug 14:S0165-0327(24)01290-4. doi: 10.1016/j.jad.2024.08.077. Online ahead of print.

ABSTRACT

BACKGROUND: The emergence of biological agents and small molecule drugs has revolutionized the treatment landscape for psoriasis, yet there remains a lack of systematic reviews elucidating the efficacy and safety of drugs for patients with psoriasis and mental disorders (MD). The aim was to systemically evaluate the efficacy and safety of FDA-approved psoriasis drugs on MD symptoms and MD drugs on psoriasis symptoms.

METHODS: We conducted comprehensive literature searches of PubMed, Embase, and the Cochrane Library from inception to March 24, 2024, identifying 116 relevant studies for inclusion.

RESULTS: Our review encompasses 62 clinical trials and 54 case reports/series. Analyses of clinical trials revealed a positive impact of psoriasis drugs on MD, with notable exceptions including lithium and benzodiazepine receptor agonists, which exhibited adverse effects on psoriasis. Furthermore, analysis of case reports/series highlighted the efficacy of drugs such as apremilast, etanercept, infliximab, and secukinumab in ameliorating MD symptoms, contrasting with detrimental effects observed with methotrexate (MTX), cyclosporine, adalimumab, and secukinumab. Notably, tumor necrosis factor alpha (TNF-α) inhibitors and interleukin inhibitors demonstrated superior efficacy compared to conventional treatments. In the anxiety group, secukinumab showed the largest effective size as assessed by the HADS-A index; In the depression group, ixekizumab showed the largest effective size assessed by the QIDS-SR16 index.

LIMITATIONS: The extracted data cannot be meta-analyzed, as the measurement scale is not uniform.

CONCLUSIONS: This systematic review provides robust evidence regarding treatment options for individuals with psoriasis and MD, emphasizing the potential benefits of specific drugs in managing both conditions concurrently.

PMID:39151762 | DOI:10.1016/j.jad.2024.08.077