WHAT ARE THE RISKS ASSOCIATED WITH THE USE OF NSAIDS AS AN ADJUNCT TO SSRIS FOR TREATMENT OF DEPRESSION? AN EVALUATION OF CURRENT EVIDENCE

Background: Over the past twenty years, psychiatric researchers have recognised the important role played by inflammation in the pathogenesis of depression. There has been increasing interest in the use of anti-inflammatory drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), as a way to enhance the efficacy of antidepressant treatments. It is essential that psychiatrists and GPs who prescribe these drugs in conjunction, understand possible interactions, particularly the risk of bleeding. Subjects and methods: This paper is a literature review regarding NSAID co-prescription with SSRIs and the potential risks and benefits. The objectives of this systematic review are to assess the evidence for the use of NSAIDs as an adjunct to standard antidepressant drugs and evaluate this against the evidence contraindicating such a treatment combination. Results: Our research suggests that there is evidence to support both the anti-inflammatory benefits of NSAIDs for treating depression, as well as evidence suggesting that NSAIDs increases the risk of bleeding when co-prescribed with SSRIs. Conclusions: When a broad consideration of the risks and benefits is done, the review is inconclusive about guidelines for co-prescription. More research is required to make strong claims about whether the type of NSAID and duration of treatment influences the risk (or benefit) of co-prescription.