transparent man's head high lighting the brainIf you’re taking a selective serotonin reuptake inhibitor (an SSRI antidepressant) that doesn’t seem to be working very well and you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to relieve pain, that NSAID may be the reason why your SSRI isn’t working.

Recently Paul Greengard PhD published a report in an online journal that strongly suggests that treatment with NSAIDs may reduce the antidepressant activity of SSRIs. Their research is based on the theory that depression is at least partially related to the body’s inflammatory responses. This is called the cytokine hypothesis and is based on observations that some chemicals released as part of inflammation – cytokines – are involved in regulating neurotransmitters such as serotonin.

It has been found that SSRIs increase levels of particular cytokines and a protein known as p11, which is also related to the cytokine theory of depression. NSAIDs abolish those effects of the SSRIs.

This study of the chemistry of SSRIs and NSAIDs helps outline the possible mechanism behind findings in the STAR*D study – a major study of people with depression – that showed NSAID use was associated with poorer response to SSRIs when they were taken with NSAIDs.

The researchers state that based on the combination of clinical and biochemical studies that now show such a strong negative relationship between these two medicines, doctors should carefully consider the risks and benefits of using NSAIDs in patients being treated for depression.

SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Celexa (citalopram), Lexapro (escitalopram), and Luvox (fluvoxamine).

NSAIDs include aspirin, ibuprofen, and celecoxib (Celebrex), to name only a few of the more common NSAIDs.

If you take SSRIs and NSAIDs you should not stop either medicine, but this is something to discuss with your doctor. The article doesn’t specifically mention whether using NSAIDs occasionally for a headache poses a problem, but the study is based on chronic exposure of cells to the anti-inflammatory agent, so I would expect that this is more of a concern for people who are taking NSAIDs regularly for more long-term pain management. Some people, however, don’t realize how often they’re taking medicines for pain – and it’s something to consider if you’re not having a positive response to your antidepressant.

Photo by Pedro Vera, available under a Creative Commons attribution license.

 


Comments


View Comments / Leave a Comment

This post currently has 3 comments.
You can read the comments or leave your own thoughts.

Trackbacks

No trackbacks yet to this post.






    Last reviewed: 26 Jul 2011

APA Reference
Fink, C. (2011). NSAIDs May Reduce Effectiveness of SSRIs. Psych Central. Retrieved on September 2, 2014, from http://blogs.psychcentral.com/bipolar/2011/07/nsaid-ssri-antidepressant/

 

Bipolar Beat


Subscribe to this Blog:
Feed

Bipolar
Disorder



Archives





Candida Fink, M.D. and Joe Kraynak are authors of
Bipolar Disorder for Dummies.


Best of the Web - Blog 2008

Subscribe to this Blog: Feed

Recent Comments
  • jaydee: i have been on 2400 mgs a day neurontin along with wellbutrin and lexapro for many years. i can say that...
  • Old girlfriend now Bipolar: Hi Eian, Based on my experience I say run run as fast as you can and don’t look...
  • Old girlfriend now Bipolar: Re-developing a relationship with my old college girlfriend 38 years. I fell back in love...
  • Jon Hansen: My partner (who is Bipolar) and I have worked through the illness for two reasons: 1. I was willing to...
  • confused: My Gf who I lived with for almost 4 years I just found out a month ago is bipolar. After our 1st year our...
Find a Therapist
Enter ZIP or postal code



Users Online: 12240
Join Us Now!