Does Xeljanz (tofacitinib) affect mood?

From the Guidelines

Xeljanz does not have a well-established link to mood changes based on the provided evidence, which primarily discusses isotretinoin. However, considering the context of the question and the need to address potential effects of Xeljanz on mood, it's essential to look into the broader implications of JAK inhibitors like Xeljanz on psychological well-being. While the provided evidence [ 1 ] focuses on isotretinoin and its effects, particularly on acne treatment and associated side effects, it does not directly address Xeljanz or its impact on mood. Given the lack of direct evidence from the provided study, we must consider general knowledge about Xeljanz (tofacitinib) and its mechanism of action as a JAK inhibitor, which might influence mood indirectly through its effects on the immune system and potentially on neurological pathways [ 1 ]. Some key points to consider in the management of patients on Xeljanz include:

• Monitoring for any changes in mood or psychological well-being, as these could be related to the underlying condition being treated or potentially to the medication itself.
• The importance of not stopping Xeljanz without medical guidance, as this could lead to a flare-up of the underlying condition.
• The potential need for dose adjustments or the addition of other treatments to manage mood symptoms if they arise. It's crucial to consult the most recent and highest quality studies specifically investigating the effects of Xeljanz on mood to provide a definitive recommendation. However, based on the information provided and general medical knowledge, if a patient on Xeljanz experiences significant mood changes, they should promptly consult their healthcare provider for evaluation and potential adjustment of their treatment plan.

From the Research

Xeljanz and Mood Effects

• There is no direct evidence in the provided studies that specifically addresses the effect of Xeljanz on mood.
• However, study 2 discusses the efficacy of tofacitinib, which is another name for Xeljanz, in patients with rheumatoid arthritis and probable depression/anxiety.
• The study found that tofacitinib improved RA symptoms and reduced the prevalence of probable major depressive disorder and/or probable generalized anxiety disorder (pMDD/pGAD) in patients with baseline pMDD/pGAD.
• The study suggests that effective treatment of underlying RA may lead to improvements in depression and anxiety, based on the SF-36 MCS score.
• It is worth noting that the study 2 does not specifically focus on the effect of Xeljanz on mood, but rather its efficacy in patients with RA and comorbid depression/anxiety.

Related Studies

• Study 3 found that tocilizumab, another biologic disease-modifying antirheumatic drug (bDMARD), reduced the risk of depression in patients with rheumatoid arthritis.
• Study 4 found that antidepressants are effective in individuals with comorbid physical conditions, including rheumatoid arthritis, although tolerability is a relevant concern.
• These studies suggest that treatment of underlying physical conditions, such as RA, may have a positive effect on mood and depression symptoms.

Limitations

• The provided studies do not directly address the effect of Xeljanz on mood, and more research is needed to fully understand its impact on depression and anxiety.
• The studies that do discuss tofacitinib or similar medications have limitations, such as the use of indirect measures of depression and anxiety, and the need for further research to confirm the findings.