Do Analgesics Interfere with Efficacy of Selective Serotonin Reuptake Inhibitors?

Comment

This elegant translational study connects the observations in a rodent depression model with possible clinical response to antidepressants. SSRIs (but not noradrenergic antidepressants) increase cytokines, which increase p11, resulting in the antidepressant response. NSAIDs (and acetaminophen) inhibit the step-activating cytokines. Clinically, worse antidepressant response is associated with analgesic use. Further research is needed, including prospective studies of various antidepressant types and studies of other possible etiologies – e.g., putatively NSAID-lowered plasma levels of SSRIs or a greater likelihood that depression will be refractory to treatment in patients with pain. Meanwhile, clinicians should carefully evaluate their depressed patients' analgesic use; it may be one reason for poor response. For patients requiring analgesics, clinicians may wish to consider non-SSRIs.

Journal Watch © 2011 

Cite this: Do Analgesics Interfere with Efficacy of Selective Serotonin Reuptake Inhibitors? - Medscape - May 01, 2011.