Antidepressant Interactions: Why Your Pill May Not Work

I've heard or read a lot lately that the antidepressants known as SSRIs (selective serotonin reuptake inhibitors) such as Zoloft, Paxil and Prozac don't work any better than placebo, a belief that stems from studies such as a widely publicized one done a few years ago, which found that SSRIs only beat placebo in a statistically significant way in patients who were severely depressed. (Though the companies that make these drugs have lots of data supporting their efficacy.)

But how can that be, I've wondered, since I've known so many people who consider these antidepressants to be lifesavers, or at least sanity savers?  Sure, I know that the placebo effect can be a powerful one, but I've heard too many testimonials from friends to believe that SSRIs don't have any merit beyond that.

So I was intrigued to hear about a recent study which may explain, at least in part, why some people experience more relief from SSRIs than others: Every day anti-inflammatory drugs such as aspirin, ibuprofen and naproxen reduce the effectiveness of these antidepressants. This seems pretty major, especially for people mid-life and older, since people in those age groups are likely to take anti-inflammatories routinely, whether aspirin to prevent heart attacks or naproxen (aka Aleve) for arthritis pain or ibuprofen for the miscellaneous aches and pains that can pile on with the years. 

The study was done at the Fisher Center for Alzheimer's Disease Research at The Rockefeller University in New York. Because people who suffer from Alzheimer's are often depressed, and that can result in worse outcomes, and because depression is a risk factor for developing Alzheimer's, these Alzheimer's researchers are eager to solve the riddle of why certain people don't respond well to SSRIs. They first conducted research on mice, and then on humans.

So if you, a spouse, or an aging parent is being treated for depression while depending on anti-inflammatories for pain, definitely raise this research with your doctors to find out how to proceed.  Perhaps there are other pain treatments, or other types of antidepressants, that won't interact in this way.

More on depression at mid-life and beyond:

The Menopause Antidepressant

The Best Depression Drugs for Elderly Parents