Can Anti-Inflammatories Treat Depression? - New Research

NSAIDs stands for non-steroidal anti-inflammatory drugs. They are medications that treat inflammation in the body but are not steroids. These are drugs like ibuprofen or Motrin, naproxen or Aleve and celecoxib or Celebrex.

There’s been a growing body research showing that people who are depressed have higher levels of inflammatory chemicals in the body. Also people with infection and autoimmune disorders have an increased risk of developing depression.

Autoimmune means your body forms antibodies to your own tissues in your body. Examples of autoimmune disorders are rheumatoid arthritis, Lupus and multiple sclerosis. Even psoriasis, which is a skin disorder, is autoimmune. So groups of people with these disorders have been studied and we’ve seen a higher incidence of depression in these groups of people.

There was a 2019 study that analyzed several randomized control trials using anti-inflammatory medications to treat depression both as an add on agent and as the only medication used – we call this monotherapy. The results showed improvement in depression with the use of NSAIDs, with celecoxib rising to the top as the one used the most. The dose used was 200mg bid.

Here’s how the drug works. NSAIDs block the enzyme, cox-2 that makes prostaglandins. Prostaglandins are chemicals that contribute to arthritis pain, fever, and pain caused by inflammation. With lower concentrations of prostaglandins, you have less inflammation, less pain and less depression. Celebrex blocks the enzyme that makes prostaglandins, so you get lower concentrations of prostaglandins.

We don’t have a complete understanding of how inflammation causes depression or vice versa. It’s not clear which comes first. So understanding this is a work in progress. And this is one reason using anti-inflammatory medications isn’t a mainstream recommendation.

Side effects
NSAIDs increase the risk of gastrointestinal bleeding. And this is something that can happen anytime during the use of the medication and not just with chronic use. Even if you don’t get bleeding, you can get pretty serious stomach upset.

Also, many of the later NSAIDs like Celebrex and Vioxx cause an increase in strokes and heart attacks. In fact Vioxx was taken off the market in 2004 because of this problem. Celebrex has remained on the market but it and other NSAIDs have a black box warning about the risk of stroke and heart attack.

A black box warning is issued by the FDA and required to go on the package information. It’s a way to emphasize serious drug side effects to insure that you are informed of the risks.

References:
Müller N. COX-2 Inhibitors, Aspirin, and Other Potential Anti-Inflammatory Treatments for Psychiatric Disorders. Front Psychiatry. 2019;10:375. Published 2019 May 31. doi:10.3389/fpsyt.2019.00375

O. Köhler‐Forsberg et. al. Efficacy of anti‐inflammatory treatment on major depressive disorder or depressive symptoms: meta‐analysis of clinical trials. Acta Psychiatr Scand. 2019 May;139(5):404-419.

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Видео Can Anti-Inflammatories Treat Depression? - New Research канала Dr. Tracey Marks