Harry Costello
@drharrycostello.bsky.social
Academic neuropsychiatrist | MD PhD | Clinical Lecturer @UCLPsychiatry | Mood, Motivation & Neurodegeneration | Aspiring apiarist
Implications for the field:
🔹 We found no evidence that mAb therapies increase depression risk in AD/PD.
🔹 Neuropsychiatric outcomes are rarely included in disease-modifying therapy trials.
🔹 Without proper measurement, we risk missing both potential benefits and harms.
🔹 We found no evidence that mAb therapies increase depression risk in AD/PD.
🔹 Neuropsychiatric outcomes are rarely included in disease-modifying therapy trials.
🔹 Without proper measurement, we risk missing both potential benefits and harms.
September 22, 2025 at 7:58 AM
Implications for the field:
🔹 We found no evidence that mAb therapies increase depression risk in AD/PD.
🔹 Neuropsychiatric outcomes are rarely included in disease-modifying therapy trials.
🔹 Without proper measurement, we risk missing both potential benefits and harms.
🔹 We found no evidence that mAb therapies increase depression risk in AD/PD.
🔹 Neuropsychiatric outcomes are rarely included in disease-modifying therapy trials.
🔹 Without proper measurement, we risk missing both potential benefits and harms.
Our meta-analysis found no significant difference in risk of depression with mAb therapy vs placebo (log risk ratio −0.24, 95% CI −0.52 to 0.04, p=0.09).
However, most trials excluded participants with depression at baseline and included no depression measures.
However, most trials excluded participants with depression at baseline and included no depression measures.
September 22, 2025 at 7:58 AM
Our meta-analysis found no significant difference in risk of depression with mAb therapy vs placebo (log risk ratio −0.24, 95% CI −0.52 to 0.04, p=0.09).
However, most trials excluded participants with depression at baseline and included no depression measures.
However, most trials excluded participants with depression at baseline and included no depression measures.
From 3000 studies we identified 13 RCTs (👥 8,603 participants: 4,690 treatment, 3,913 placebo)
All reported depression incidence as an adverse event.
‼️ *But* NONE assessed change in depressive symptom severity with mood scales.
All reported depression incidence as an adverse event.
‼️ *But* NONE assessed change in depressive symptom severity with mood scales.
September 22, 2025 at 7:58 AM
From 3000 studies we identified 13 RCTs (👥 8,603 participants: 4,690 treatment, 3,913 placebo)
All reported depression incidence as an adverse event.
‼️ *But* NONE assessed change in depressive symptom severity with mood scales.
All reported depression incidence as an adverse event.
‼️ *But* NONE assessed change in depressive symptom severity with mood scales.
Why does this matter?
#Depression is common (40% of pts), disabling & tough to treat in AD/PD.
Monoclonal antibodies (like lecanemab, donanemab etc) target pathological proteins (eg amyloid) but also trigger inflammatory & vascular changes—all mechanisms linked to depression.
#Depression is common (40% of pts), disabling & tough to treat in AD/PD.
Monoclonal antibodies (like lecanemab, donanemab etc) target pathological proteins (eg amyloid) but also trigger inflammatory & vascular changes—all mechanisms linked to depression.
September 22, 2025 at 7:58 AM
Why does this matter?
#Depression is common (40% of pts), disabling & tough to treat in AD/PD.
Monoclonal antibodies (like lecanemab, donanemab etc) target pathological proteins (eg amyloid) but also trigger inflammatory & vascular changes—all mechanisms linked to depression.
#Depression is common (40% of pts), disabling & tough to treat in AD/PD.
Monoclonal antibodies (like lecanemab, donanemab etc) target pathological proteins (eg amyloid) but also trigger inflammatory & vascular changes—all mechanisms linked to depression.
The studies I’m thinking of ⬇️. Any others?
jamanetwork.com/journals/jam...
www.thelancet.com/journals/lan...
jamanetwork.com/journals/jam...
www.thelancet.com/journals/lan...
September 13, 2025 at 7:58 PM
The studies I’m thinking of ⬇️. Any others?
jamanetwork.com/journals/jam...
www.thelancet.com/journals/lan...
jamanetwork.com/journals/jam...
www.thelancet.com/journals/lan...