Dr. Manny Comments: Common Painkillers May Decrease Effectiveness of Anti-Depressants

According to scientists at the Fisher Center for Alzheimer’s Disease Research at The Rockefeller University in New York City, common pain killers may interfere with the function of some antidepressants.

More specifically non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, aspirin and naproxen, can actually reduce the effectiveness of selective serotonin reuptake inhibitors, or SSRIs, the most widely prescribed type of antidepressants. Popular SSRIs include name brands such as Prozac, Paxil and Zoloft.

This finding by Dr. Paul Greengard and his team is incredibly significant, because chronic pain is often a secondary characteristic of many depressive disorders, and the use of over-the-counter anti-inflammatory drugs is quite high among depressed people.

The discovery came about in the course of research led by Dr. Greengard and Dr. Jennifer Warner-Schmidt into the link between Alzheimer’s disease and depression.  I find it very exciting to see that Dr. Greengard and his colleagues are making headway in understanding the biology of this devastating disease.

It’s long been known that depression is often found in Alzheimer’s patients, but the implications of this new study affect far more than the 5.4 million Americans living with the disease.  Clinical depression has been diagnosed in nearly 19 million American adults – about 10 percent of the population.  This makes it one of the most commonly treated medical conditions.  Experts argue that the real number of people suffering from depression is even higher because depressive disorders often go undiagnosed or untreated.

Anti-depressants, in turn, have become the most commonly prescribed drugs in the US, and are prescribed more than drugs that treat high blood pressure, high cholesterol, asthma, or headaches, according to the Centers for Disease Control and Prevention (CDC). Of all the antidepressants available, SSRIs remain the most popular because they are typically safe, effective and less likely to cause unwanted side effects.

SSRIs work by blocking the reabsorption of serotonin in the brain, which aids brain cells in sending and receiving chemical messages and subsequently boosts a person’s mood. These drugs help correct chemical imbalances of depression patients, but according to Dr. Greengard’s team of scientists, that might be exactly why they become ineffective when taken with popular over-the-counter anti-inflammatory medications.

Many patients have to switch antidepressants due to lack of effectiveness at some point during treatment. This latest finding illuminates one possible mechanism for medication failure, and I believe it will help doctors counsel patients better concerning the secondary side effects of SSRIs.

Personally, I know I’ll think twice in my own practice when treating patients taking SSRIs in combination with anti-inflammatory medications.

Like all significant medical findings, I have no doubt that there will be many more studies to follow. But my hope is that in the meantime, this study helps to open up the dialogue and reevaluate the course of action when it comes to treating depression, to improve the standard of care for these patients.