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NSAIDs interfere with SSRIs


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The Wall Street Journal

26 Apr 11

by Shirley S. Wang

 

....Researchers found that painkillers such as aspirin and ibuprofen appear to decrease the effectiveness of a popular class of antidepressants that includes Prozac and Celexa.

 

The finding, published Monday, may help explain why even the most effective antidepressants don't work for everyone. At best only about two-thirds of patients respond effectively to Celexa and other selective serotonin reuptake inhibitors, or SSRIs....

 

It isn't clear from the study whether taking ibuprofen for an occasional headache is enough to blunt the effect of an antidepressant or whether it takes long-term use for a condition such as arthritis for there to be an inhibitory effect.....

 

Antidepressants, the bulk of which are SSRIs, were the second most popular drug class prescribed in the U.S. last year, netting $11.6 billion in sales, according to IMS Health, which tracks pharmaceutical sales.....

 

There were 253 million prescriptions for antidepressants in the U.S. in 2010.

 

The Rockefeller researchers initially looked at changes of a biochemical marker of depression in mice when the animals were consistently given an SSRI, an anti-inflammatory or both medicines.

 

They figured if there was any effect from combining the two, it would have been to improve depressive symptoms since inflammation, an immune system response to infection, it thought to worsen or even cause depression in some people, Dr. Warner-Schmidt said.

 

Instead, they found that mice given a combination regimen had a dampened response—and sometimes no response—to the antidepressant compared to the group that got the SSRI alone. Mice who received just the anti-inflammatory didn't show any change in the protein marker, called p11.

 

The researchers then looked to see if there was any evidence of this effect in humans. By examining data from an already-completed 4,000-patient large clinical trial of depressed patients known as STAR*D, they found that there was indeed a significant difference. Depressive symptoms—such as feeling down, crying more frequently than usual or having decreased appetite—in patients who took Celexa went away 55% of the time, but that rate dropped to 45% in individuals who reported they also had taken an anti-inflammatory.

 

Madhukar Trivedi, who co-led the STAR*D trial and wasn't involved in the new study, called the mouse data "clearly compelling" and the STAR*D analysis "very fascinating" but in need of follow-up.....

 

It isn't clear why NSAIDs suppress the effect of SSRIs, but it could be simply an interaction between the drugs where NSAIDs prevent SSRIs from reaching the brain, the researchers said.....

 

Write to Shirley S. Wang at shirley.wang@wsj.com

 

http://online.wsj.com/article/SB10001424052748704132204576285183033104082.html

1996-97 - Paxil x 9 months, tapered, suffered 8 months withdrawal but didn't know it was withdrawal, so...

1998-2001 - Zoloft, tapered, again unwittingly went into withdrawal, so...

2002-03 - Paxil x 20 months, developed severe headaches, so...

Sep 03 - May 05 - Paxil taper took 20 months, severe physical, moderate psychological symptoms

Sep 03 - Jun 05 - took Prozac to help with Paxil taper - not recommended

Jul 05 to date - post-taper, severe psychological, moderate physical symptoms, improving very slowly

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So many opportunities to use the :blink: emoticon here!

1996-97 - Paxil x 9 months, tapered, suffered 8 months withdrawal but didn't know it was withdrawal, so...

1998-2001 - Zoloft, tapered, again unwittingly went into withdrawal, so...

2002-03 - Paxil x 20 months, developed severe headaches, so...

Sep 03 - May 05 - Paxil taper took 20 months, severe physical, moderate psychological symptoms

Sep 03 - Jun 05 - took Prozac to help with Paxil taper - not recommended

Jul 05 to date - post-taper, severe psychological, moderate physical symptoms, improving very slowly

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Share on other sites
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I wish I had one for being speechless.

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