Non-steroidal anti-inflammatory drugs and efficacy of antidepressants in major depressive disorder
Abstract
Background: It has been proposed that non-steroidal anti-inflammatory drugs (NSAIDs) may interfere with the efficacy of antidepressants and contribute to treatment resistance in major depressive disorder (MDD). This effect requires replication and a test of whether it is specific to serotonin-reuptake inhibiting (SRI) antidepressants. Method: We tested the effect of concomitant medication with NSAIDs on the efficacy of escitalopram, a SRI antidepressant, and nortriptyline, a tricyclic antidepressant, among 811 subjects with MDD treated for up to 12 weeks in the GENDEP study. Effects of NSAIDs on improvement of depressive symptoms were tested in mixed-effect linear models. Effects on remission were tested in logistic regression. Age, sex, baseline severity and centre of recruitment were considered as potential confounding factors. Results: Ten percent (n=78) of subjects were taking NSAIDs during the antidepressant treatment. Older subjects were significantly more likely to take NSAIDs. After controlling for age, sex, centre of recruitment and baseline severity, concomitant medication with NSAIDs did not significantly influence the efficacy of escitalopram [β=0.035, 95% confidence interval (CI) −0.145 to 0.215, p=0.704] or nortriptyline (β=0.075, 95% CI −0.131 to 0.281, p=0.476). Although slightly fewer subjects who took NSAIDs reached remission [odds ratio (OR) 0.80, 95% CI 0.49–1.31, p=0.383], this non-significant effect was reversed after controlling for age, sex, baseline severity and recruitment centre effects (OR 1.04, 95% CI 0.61–1.77, p=0.882). Conclusions: NSAIDs are unlikely to affect the efficacy of SRI or other antidepressants. Concurrent use of NSAIDs and antidepressants does not need to be avoided.
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The effects of citalopram, which regulates TNF-α and IFN-γ in mouse frontal lobe, are inhibited by ibuprofen.
“The effects of citalopram, which regulates TNF-α and IFN-γ in mouse frontal lobe, are inhibited by ibuprofen[68].”
From Neuroinflammation and cytokine abnormality in major depression: cause or consequence in that illness? (2016) · cites this paper as [68]
The combination of SSRIs and non-steroidal anti-inflammatory drugs inhibits the effects of the antidepressant.
“However, the combination of SSRIs and non-steroidal anti-inflammatory drugs inhibits the effects of the antidepressant.”
From Neuroinflammation and cytokine abnormality in major depression: cause or consequence in that illness? (2016) · cites this paper as [68]
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- Authors
- Uher, R., Carver, S., Power, R. A., Mors, O., Maier, W., Rietschel, M., Hauser, J., Dernovsek, M. Z., Henigsberg, N., Souery, D., Placentino, A., Farmer, A., & McGuffin, P.
- Affiliations
- Dalhousie University (CA)
- King's College London (GB)
- Aarhus University Hospital (DK)
- University of Bonn (DE)
- Central Institute of Mental Health (DE)
- Poznan University of Medical Sciences (PL)
- University of Zagreb (HR)
- Université Libre de Bruxelles (BE)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Corresponding author
- Uher, R.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-03-06
- Volume
- 42
- Issue
- 10
- Pages
- 2027-2035
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2056757508
- Cited by
- 45
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2020: 1 · 2019: 4 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 4 · 2012: 1
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- nonsteroidal anti-inflammatory drugs, major depressive disorder, antidepressant efficacy, escitalopram, nortriptyline, serotonin reuptake inhibitors, tricyclic antidepressants, treatment resistance, concomitant medications, remission
- MeSH terms
- Adult, Anti-Inflammatory Agents, Non-Steroidal, Antidepressive Agents, Tricyclic, Major Depressive Disorder, Drug Interactions, Female, Humans, Male, Middle Aged, Nortriptyline, Severity of Illness Index, Citalopram, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Age Distribution, Sex Distribution
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