Why Your Antidepressant May Not Be Working

Scientists at the Fisher Center for Alzheimer’s Disease Research at The Rockefeller University in New York City have made a significant discovery in the treatment of patients with depression. They found that non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, aspirin and naproxen, actually reduce the effectiveness of the most widely used class of antidepressants, known as selective serotonin reuptake inhibitors, or SSRIs. Some of the most popular SSRIs include name brands such as Prozac, Paxil and Zoloft.

In my opinion, the findings that the use of anti-inflammatory may decrease the effectiveness of many antidepressant medications, by Dr. Paul Greengard and his team are very significant, because chronic pain is often a secondary characteristic of many depressive disorders, and the use of over-the-counter anti-inflammatory drugs is quite high.

This unexpected discovery came about as a result of research by the scientific team at the Fisher Foundation, led by Dr. Greengard and Dr. Jennifer Warner-Schmidt, into the link between Alzheimer’s disease and depression. It is very exciting to me that Dr. Greengard and his team are really beginning to gain an understanding of some of the biology behind this devastating disease.

We know that depression is often found in patients with Alzheimer’s, but the implications of this discovery reach far beyond the 5.4 million Americans living with the disease. Clinical depression is one of the most commonly treated medical conditions, affecting nearly 19 million Americans adults – which is about 10 percent of the population. But some experts argue that number should probably be higher, since depressive disorders often go undiagnosed or untreated.

Over the last decade, antidepressants have become the most commonly prescribed drugs in the United States, and are prescribed more than drugs to treat high blood pressure, high cholesterol, asthma, or headaches, according to the Centers for Disease Control and Prevention (CDC). And of all the antidepressants out there, SSRIs remain the most popular because of their reputation as being safe, effective and less likely to cause unwanted side effects.

SSRIs ease the symptoms of depression by blocking the reabsorption of serotonin in the brain, which helps brain cells send and receive chemical messages and boosts your mood. These drugs help to correct chemical imbalances that are common in depression patients, but according to Dr. Greengard’s team of scientists, that might be exactly why they become ineffective when taken with popular over-the-counter anti-inflammatory medications.

Many patients have to switch antidepressants for lack of effectiveness at some point during their treatment. This finding highlights one possible mechanism for medication failure, and I think it will help doctors counsel patients better when it comes to considering secondary side effects of SSRIs. Personally, I know I’ll think twice in my own practice when treating patients taking SSRIs in combination with anti-inflammatory medications.

Like all significant medical findings, I’m sure there will be many more studies to follow. But my hope is that in the meantime, this study helps to open up the dialogue and reevaluate the course of action when it comes to treating depression, to improve the standard of care for these patients.