Exploring early add-on celecoxib treatment in OCD: Results from a preliminary randomized, double-blind, placebo-controlled trial

Background: Despite multiple treatment options available for obsessive-compulsive disorder (OCD), the response still remains unsatisfactory due to various factors. Hence, there is a continuous need to explore newer treatment modalities for OCD. Neuroinflammation might be one such contributing factor. Aim: We aimed to study the clinical outcome of early Celecoxib (Selective Cyclooxygenase-2 Inhibitor) add-on therapy to fluoxetine treatment in OCD over 8 weeks and explored the association of the outcomes with biochemical parameters, serum interleukin-6 (IL-6) and brain-derived neurotrophic factor (BDNF). Methods: Forty-four drug-naive patients diagnosed with OCD (as per International Classification of Diseases-10) were recruited and randomized into 2 groups of 22 participants each. The study participants received fluoxetine and celecoxib (800 mg/day), and the control group received fluoxetine and a placebo. The clinical variables were measured at 0, 2, 4 and 8 weeks using the standard Yale-Brown Obsessive Compulsive Scale (YBOCS) for severity of symptoms. Serum IL-6 and BDNF were assessed at 0 and 8 weeks. Results: The study group showed a greater mean change (6.56 ± 1.04) of YBOCS scores over 8 weeks ( p ⩽ 0.001, Hedge’s g = 1.918). Response rate was higher in the study group (33%) than in controls (11.1%; Number Needed to Treat = 4.2). Reduction in YBOCS scores was positively correlated with the decrease in inflammatory marker (IL-6) in the study group ( r = 0.478, p = 0.033). No significant side effects were observed. Conclusion: Celecoxib holds promise as a potentially safe early add-on treatment in OCD for rapid improvement in psychopathology, with further research warranted in this area. Clinical trial registration: The study was registered with the Clinical Trial Registry of India (Reference no. CTRI/2022/01/039407). https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=64361&EncHid=59518.51563&modid=1&compid=19