PhysOrg Mobile: Ibuprofen, aspirin, other anti-inflammatory drugs reduce effectiveness of SSRI antidepressants

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Ibuprofen, aspirin, other anti-inflammatory drugs reduce effectiveness of SSRI

antidepressants

Apr 25, Medicine & Health/Medications

Scientists at the Fisher Center for Alzheimer's Disease Research at The

Rockefeller University, led by Greengard, Ph.D., and

Warner-Schmidt, Ph.D., have shown that anti-inflammatory drugs, which include

ibuprofen, aspirin and naproxen, reduce the effectiveness of the most widely

used class of antidepressant medications, the selective serotonin reuptake

inhibitors, or SSRIs, taken for depression and obsessive-compulsive disorder and

anxiety disorders.

This surprising discovery, published online this week in the Proceedings of the

National Academy of Sciences, may explain why so many depressed patients taking

SSRIs do not respond to antidepressant treatment and suggests that this lack of

effectiveness may be preventable. The study may be especially significant in the

case of Alzheimer's disease. Such patients commonly suffer from depression and

unless this can be treated successfully, the course of the illness is likely to

be more severe. Depression in the elderly is also a risk factor for developing

Alzheimer's Disease and researchers have suggested that treating depression in

the elderly might reduce the risk of developing the disease.

In the recent study, investigators treated mice with antidepressants in the

presence or absence of anti-inflammatory drugs. They then examined how the mice

behaved in tasks that are sensitive to antidepressant treatment. The behavioral

responses to antidepressants were inhibited by anti-inflammatory/analgesic

treatments. They then confirmed these effects in a human population. Depressed

individuals who reported anti-inflammatory drug use were much less likely to

have their symptoms relieved by an antidepressant than depressed patients who

reported no anti-inflammatory drug use. The effect was rather dramatic since, in

the absence of any anti-inflammatory or analgesic use, 54 percent of patients

responded to the antidepressant, whereas success rates dropped to approximately

40 percent for those who reported using anti-inflammatory agents.

" The mechanism underlying these effects is not yet clear. Nevertheless, our

results may have profound implications for patients, given the very high

treatment resistance rates for depressed individuals taking SSRIs, " notes Dr.

Warner-Schmidt.

Dr. Greengard adds, " Many elderly individuals suffering from depression also

have arthritic or related diseases and as a consequence are taking both

antidepressant and anti-inflammatory medications. Our results suggest that

physicians should carefully balance the advantages and disadvantages of

continuing anti-inflammatory therapy in patients being treated with

antidepressant medications. "

Provided by Rockefeller University

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