When taken together, antidepressants and nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen increase the risk of intracranial bleeding, according to a new study published in The BMJ.
The authors of the study wrote that depression produces the greatest deterioration of health of all common chronic conditions and is especially troublesome for older adults. About 65 percent of adults with major depression also suffer chronic pain. Many of these individuals are prescribed antidepressants to treat their condition, but the medications are known to increase the risk of gastrointestinal bleeding, as are NSAIDs. The study was launched out of concern that antidepressants and NSAIDs could interact unfavorably with each other, according to MedicalNewsToday.com (MNT).
For the study, Korean researchers obtained data on 4,145,226 individuals from the Korean nationwide health insurance database for every first-time antidepressant prescription in that country from 2009 to 2013. The team also obtained NSAID prescriptions and hospital records to identify any admissions for intracranial hemorrhages within a month of a new prescription, MNT reported.
The researchers found a higher 30-day risk of intracranial hemorrhage over the course of the study in patients taking a combination of antidepressants and NSAIDs than in patients taking only antidepressants. The scientists found no significant differences in intracranial bleeding risk among different forms of antidepressants, or with the age of the patients. The risk was found to be greater among men using both drugs, according to MNT.
In the study, which was obtained by MNT, the researchers wrote that they believe that “special attention is needed when patients use both these drugs together.” The researchers added that physicians should exercise caution when prescribing antidepressant drugs and NSAIDs together and be sure to discuss the risks with patients. The findings may also “be especially relevant in areas of high socioeconomic deprivation, where the combination of mental and physical problems is very common,” they added.
Last year, 749 million over-the-counter (OTC) NSAIDs were sold in the U.S. – 13 percent of all OTC medications. Popular OTC NSAIDs include Advil, Aleve and Motrin, MNT reports.