Can Aspirin Decrease the Effectiveness of Your Antidepressant?
Not so long ago I wrote about a study showing that exposure to aspirin is associated with a reduction in the risk for developing clinical depression in women. Some researchers have hypothesized that depression may be caused by chronic brain inflammation. This theory is what led to an investigation as to whether anti-inflammatory treatments such as taking aspirin could decrease the symptoms of depression. Recently, however, there is a new study which seems to indicate the opposite.
Researchers from Rockefeller University found that anti-inflammatory medications such as ibuprofen, aspirin, and naproxen may diminish the effectiveness of antidepressant medications called SSRI's or selective serotonin reuptake inhibitors. Some popular name brand SSRI's include Celexa, Lexapro, Prozac, Paxil, and Zoloft.
Specifically the scientists found that the success rate of antidepressant effectiveness was 54% for those who did not take any anti-inflammatory medications. This rate plummeted to approximately 40 percent for those patients who were taking non-steroidal anti-inflammatory drugs, or NSAIDs, such as aspirin or ibuprofen.
The Rockefeller Univeristy study was published online earlier this week in the Proceedings of the National Academy of Sciences.
These findings may be particularly relevant to the elderly population as some older patients regularly take an antidepressant to treat their depression as well as an anti-inflammatory drug to treat conditions such as arthritis or other health conditions which may cause chronic pain. Patients with Alzheimer's Disease may also be affected as both antidepressants and NSAIDs have been used in the prevention and treatment for this disorder.
What is a patient to make of these seemingly contradictory studies? In one case the researchers are telling us that the use of aspirin and other NSAIDs may help to decrease symptoms of depression. In this later study they are warning us that taking these pain relievers may reduce the effectiveness of our antidepressant and inevitably increase our symptoms of depression. A critical question which remains unanswered by any of these studies is how much anti-inflammatory medication are we talking about? If one takes a SSRI such as Prozac and you take some aspirin every now and then for headaches, does this sporadic usage necessarily decrease the effectiveness of your anti-depressant? And at what dosage does this reduction in antidepressant effectiveness take place? Clearly, further research is needed to answer these types of questions.
In the meantime"
If you are a patient who takes an SSRI antidepressant as well as NSAIDs such as aspirin, ibuprofen, or Naproxen, it may be a good idea to talk to your doctor about the possible interactions between your medications. You may print out this article or the links to the studies mentioned above to discuss with your doctor.
In addition here are some questions you may wish to ask your physician:
1. Are these studies relevant to my situation?
2. What are the known interactions between my pain medications and my antidepressant?
3. At what dosage or frequency could I expect my pain medication to reduce the effectiveness of my antidepressant?
4. How can I monitor my pain or depression levels to know if there is an adverse interaction between my medications?
5. What are the benefits or challenges of changing either my antidepressant or pain killer medications? Would a change of either medication be advantageous or risky for me in my situation?
We would love to know your thoughts on this topic. First of all are you a patient who takes both an SSRI and NSAID medication? Does this study worry you or do you feel that it is too early to make decisions based on this preliminary research? Will you talk to your doctor about these findings? We are eager to hear your opinion.
For more information on this topic please refer to the following resources and articles:
Aspirin and Prozac Can Mix Badly, Study Says (The Wall Street Journal)
Why Painkillers Interfere with Anti-depressants (Health Central)
New Study Shows Aspirin May Prevent and Treat Depression (Health Central)
The Medication Cocktail: Is it Safe? (Health Central)