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Anakinra is given by sub-cutaneous injection once weekly. National Rituximab is a monoclonal antibody that destroys B lymphocytes. It was previously licensed only for the treatment of particular types of leukaemia. Since November arthritis, where other treatments, including anti TNF-α have failed to produce an adequate response.

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However, the full explanation of how the drugs work is still unknown and it can take many weeks for them to have an effect. Unipolar depression is associated with a decrease in noradrenaline andor serotonin activity and drugs effective in its treatment increase the concentration of one or both these transmitters at their synapses. Bipolar depression is associated with a decrease in dopamine activity and mania with an increase in dopamine activity.

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