The efficacy of pentoxifylline for major depressive disorder: A systematic review and meta-analysis of randomized controlled trials

Background: Major depressive disorder (MDD) is a widespread mental health issue; however, despite various antidepressant treatments many patients do not achieve full remission or continue to experience residual symptoms. This systematic review and meta-analysis evaluated the efficacy of pentoxifylline for MDD. 

Methods: A comprehensive literature search was conducted to identify randomized controlled trials (RCT) that evaluated the efficacy of pentoxifylline as an adjunctive therapy in the treatment of MDD. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were pooled using a random effects meta-analysis model due to the expected heterogeneity among studies. 

Results: Four studies met the inclusion criteria and were included. The included studies comprised a total of 292 participants diagnosed with MDD. Participants’ ages ranged from 18 to 65 years, and all had a Hamilton Depression Rating Scale (HAM-D) score of at least 18. The pooled analysis showed a significant improvement in response rates for the pentoxifylline group compared to the control group (pooled odds ratio [OR] 6.85, 95% confidence interval, CI: 3.42, 13.73), indicating a much higher likelihood of treatment response. Remission rates favored the pentoxifylline group, with a pooled OR of 6.09 (95% CI: 3.11, 11.91), suggesting a significantly higher likelihood of achieving remission with pentoxifylline. 

Conclusion: Our findings support the potential of pentoxifylline as an effective treatment for MDD; however, further research is needed to fully establish its efficacy across different patient populations.