Anti-inflammatory medications make SSRI antidepressants less effective, researchers from Rockefeller University explain in the journal Proceedings of the National Academy of Sciences. Examples of anti-inflammatory drugs include aspirin, naproxen and ibuprofen.

Examples of SSRIs (selective serotonin reuptake inhibitors) include:

  • citalopram (Celexa, Cipramil, Cipram, Dalsan, Recital, Emocal, Sepram, Seropram, Citox, Cital)
  • dapoxetine (Priligy)
  • escitalopram (Lexapro, Cipralex, Seroplex, Esertia)
  • fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Ladose, Motivest,Flutop, Fluctin (EUR), Fluox (NZ), Depress (UZB), Lovan (AUS))
  • fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox)
  • paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Divarius, Rexetin, Xetanor, Paroxat, Loxamine, Deparoc)
  • sertraline (Zoloft, Lustral, Serlain, Asentra)

The authors say their discovery, which was done initially with mice and later in humans, may explain why some patients on SSRIs do not appear to derive any benefits. They add that this lack of efficacy may be preventable if patients stayed off anti-inflammatory medications.

Scientists treated mice with SSRIs and gave some of them anti-inflammatory drugs, while others were given SSRIs without anti-inflammatories. They observed the animals’ behavior when given tasks which are sensitive to antidepressant treatment. They found that those on anti-inflammatory drugs showed inhibited behavioral responses.

They also found that human patients with depression who were on both SSRIs and anti-inflammatory drugs had a significantly lower chance of experiencing relief of symptoms typically offered by antidepressants compared to similar patients who did not take anti-inflammatory medications.

They found that:

  • Only 40% of patients on antidepressants and anti-inflammatory drugs responded to their SSRI medication
  • 54% of patients on SSRIs and not on anti-inflammatory medications responded to their SSRI drug

Jennifer Warner-Schmidt, said:

“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.”

Paul Greengard said:

“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.”

The researchers explain that a significant number patients with Alzheimer’s disease, for example, suffer from depression, which needs to be treated effectively to prevent more severe Alzheimer’s symptoms. They add that depression among elderly individuals also raises the risk of developing Alzheimer’s. If depression can be treated effectively, most likely the chances of developing Alzheimer’s would be reduced.

“Antidepressant effects of selective serotonin reuptake inhibitors (SSRIs) are attenuated by antiinflammatory drugs in mice and humans”
Jennifer L. Warner-Schmidta, Kimberly E. Vanoverb, Emily Y. Chena, John J. Marshalla, and Paul Greengard
Proceedings of the National Academy of Sciences doi: 10.1073/pnas.1104836108

Written by Christian Nordqvist