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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Phillipa on October 22, 2014, at 9:49:45
Would explain why two years ago took 800mg of motrin for 24 hours and felt the best in years.
Medscape Medical News > Psychiatry
Anti-inflammatories May Help Ease Depression
Megan Brooks
October 21, 2014Nonsteroidal anti-inflammatory drugs (NSAIDs) may help ease depressive symptoms, new research suggests.
Results of a meta-analysis show that the adjunctive use of NSAIDs was associated with improved antidepressant treatment response without an increased risk for adverse effects. In particular, add-on treatment with celecoxib (Celebrex, GD Searle LLC) improved antidepressant effects, remission, and response.
"Our analysis suggests that anti-inflammatory treatment, in particular celecoxib, decreases depressive symptoms without increased risks of adverse effects," the authors, led by Ole Kohler, MD, of Aarhus University Hospital, Risskov, Denmark, write.
The study was published online October 15 in JAMA Psychiatry.
Need for RCTs
"Compelling" evidence suggests a link between depression and inflammation. Several studies have investigated whether the use of anti-inflammatory agents might exert antidepressant effects, with conflicting results, the authors note.
To investigate further, they conducted a systematic review and meta-analysis of 14 relevant randomized, placebo-controlled trials that assessed the efficacy and adverse effects of anti- inflammatory drug therapy in a total of 6262 adults with depressive symptoms or depression.
The pooled effect estimate suggested that anti-inflammatory treatment reduced depressive symptoms, compared with placebo, with a standard mean difference (SMD) of -0.34 (95% confidence interval [CI], −0.57 to −0.11).
The antidepressant effect was evident in studies that included patients with depression (SMD, −0.54; 95% CI, −1.08 to −0.01) and depressive symptoms (SMD, −0.27; 95% CI, −0.53 to −0.01).
The analyses favored anti-inflammatory treatment over placebo for both remission (odds ratio [OR], 2.73) and response (OR, 2.41).
Celecoxib as an adjunct to antidepressant treatment seemed most beneficial compared with placebo (SMD -0.82; 95% CI, -1.17 to -0.46, P < .001). Celecoxib add-on improved both remission (OR, 7.89; 95% CI, 2.94 - 21.17, P < .001) and response (OR, 6.59; 95% CI, 2.24 - 19.42; P < .001).
Cytokine inhibitors were studied in few trials and did not provide significantly better antidepressant treatment effects over placebo, the researchers note.
Neither NSAIDs nor cytokine inhibitors were associated with an increased risk for adverse effects, although not all studies reported adverse effects.
The investigators also note that most studies were small and of short duration, and most of the observed effect sizes were small to medium with high heterogeneity. The studies also had a "high risk of bias," which "tended to exaggerate treatment effects."
Nonetheless, their results provide "proof-of-concept concerning the use of anti-inflammatory agents in the antidepressant treatment regimen."
"Our findings emphasize the need for identifying subgroups that may benefit more from anti-inflammatory intervention, such as patients with elevated inflammatory markers or a somatic comorbidity. Specific agents, particularly celecoxib, showed promising results and should therefore be investigated in high-quality randomized clinical trials. Such trials should carefully report on adverse effects and include long-term follow-up," they write.
The authors report no relevant financial relationships.
JAMA Psychiatry. Published online October 15, 2014. Abstract
Posted by Beckett on October 22, 2014, at 15:02:42
In reply to Anti-Inflammatory's May Help Depression, posted by Phillipa on October 22, 2014, at 9:49:45
Hi P.
I don't see a dosage. And I thought chronic NSAID use could be harmful. What do you think?
Posted by Phillipa on October 22, 2014, at 16:01:59
In reply to Re: Anti-Inflammatory's May Help Depression, posted by Beckett on October 22, 2014, at 15:02:42
Confused as I've already googled and the NSAIDs & Cox inhibitors are still bad. Heart attack, stroke, gastro bleeding? So much conflicting studies lately. Makes one afraid to take anything. What are your thoughts? P
Posted by oceansun on October 22, 2014, at 19:21:35
In reply to Anti-Inflammatory's May Help Depression, posted by Phillipa on October 22, 2014, at 9:49:45
200-400 mg/day, which is an average dose. 4-6 weeks to work, and only with another antidepressant, I think only SSRIs.
I did my own experiment for one week and didn't feel any difference, but that wasn't long enough. I do feel better when I take ibuprofen in particular, but I think that's because it takes my headaches away :).
Yeah, Celebrex can have some scary side effects, but I think usually there aren't any side effects.
Posted by Phillipa on October 22, 2014, at 20:06:22
In reply to Re: Anti-Inflammatory's May Help Depression, posted by oceansun on October 22, 2014, at 19:21:35
Oceansun may I ask your age or approximate age? I never took a Cox inhibitor. But about three years ago a dentist who was doing work on me prescribed motrin or generic I had at 800mg four times a day for 24 hours only. Strangely the next day felt the best I had in a long time. I honestly don't know what to make of this? I've taken zymafled from health food store. Supposed to be an anti inflammatory supplement. Noticed nothing so stopped it. I'm admit to being perplexed as also get headaches. Usually at night. Phillippa
Posted by oceansun on October 22, 2014, at 20:24:26
In reply to Re: Anti-Inflammatory's May Help Depression » oceansun, posted by Phillipa on October 22, 2014, at 20:06:22
I'm so glad you wrote this! I'm a woman in my mid-forties, and I had the CRP level done in my early forties. I too was prescribed super-ibuprofen after a dentist visit and remember feeling great! I've always wanted to try that again - this is a great idea, maybe I'll ask my doctor for a script. Funny, Aleve (naproxen) does nothing for me. Maybe there's something special about ibuprofen.
> Oceansun may I ask your age or approximate age? I never took a Cox inhibitor. But about three years ago a dentist who was doing work on me prescribed motrin or generic I had at 800mg four times a day for 24 hours only. Strangely the next day felt the best I had in a long time. I honestly don't know what to make of this? I've taken zymafled from health food store. Supposed to be an anti inflammatory supplement. Noticed nothing so stopped it. I'm admit to being perplexed as also get headaches. Usually at night. Phillippa
Posted by Phillipa on October 22, 2014, at 20:31:31
In reply to Re: Anti-Inflammatory's May Help Depression » Phillipa, posted by oceansun on October 22, 2014, at 20:24:26
How interesting. Maybe we have found a cure or treatment for inflammation. But do have to be concerned about heart, stroke, gastro bleeding. So would be a one day deal. I just took 200mg x 2 so it was 400mg I think. No script so had to be less than 800mg? Phillipa
Posted by oceansun on October 22, 2014, at 20:42:40
In reply to Re: Anti-Inflammatory's May Help Depression » oceansun, posted by Phillipa on October 22, 2014, at 20:31:31
I don't have the bottle anymore and can't really remember, but it was probably 800 mg every 4-6 hours because it was supposed to be as good as codeine for a root canal.
I've had way too much coffee today, so I'm being a little hyper about this :).
> How interesting. Maybe we have found a cure or treatment for inflammation. But do have to be concerned about heart, stroke, gastro bleeding. So would be a one day deal. I just took 200mg x 2 so it was 400mg I think. No script so had to be less than 800mg? Phillipa
Posted by gadchik on October 23, 2014, at 15:58:29
In reply to Re: Anti-Inflammatory's May Help Depression » Phillipa, posted by oceansun on October 22, 2014, at 20:42:40
My husband's on 800mg pills ibuprofen rx for a back injury. Maybe I should take one? Im not depressed tho, just hormonal. Phillipa, I too have headaches at night, sometimes awakening to a pounding on one side, and just remember it next day. I read they're called "cluster" headaches.
Posted by Phillipa on October 23, 2014, at 21:07:11
In reply to Re: Anti-Inflammatory's May Help Depression, posted by gadchik on October 23, 2014, at 15:58:29
G not as bad as cluster headaches. I started thinking today if something like claritin could also act as anti Inflammatory. As if for allergies including rashes that's inflammation isn't it? And don't think any warning. I need to check this though. P
Posted by gadchik on October 24, 2014, at 15:02:55
In reply to Re: Anti-Inflammatory's May Help Depression » gadchik, posted by Phillipa on October 23, 2014, at 21:07:11
Claritin has a good effect on me. B4 I ever took benzos, it calmed my anxiety. I always take it if I dev allergies or if Im going on a ship, to help with my dizziness. I dont know about the anti inflammatory properties, though.
Posted by Phillipa on October 24, 2014, at 20:27:06
In reply to Re: Anti-Inflammatory's May Help Depression » Phillipa, posted by gadchik on October 24, 2014, at 15:02:55
G googled it and didn't see a thing about anti inflammatory at all. Oh well back to figuring this out. There is a solution to every problem. P
Posted by Chris O on October 25, 2014, at 0:47:23
In reply to Re: Anti-Inflammatory's May Help Depression » oceansun, posted by Phillipa on October 22, 2014, at 20:06:22
I have taken many bottles of New Chapter's Zyflamed (or whatever it's called) as well as other brands of turmeric, and not noticed any antidepressant effect. Would be lovely if the Cox inhibitor study turned out to be true, though. Seems like a relatively easy "treat" compared to all the stuff most of us here have tried.
Chris
Posted by Phillipa on October 25, 2014, at 20:04:12
In reply to Re: Anti-Inflammatory's May Help Depression » Phillipa, posted by Chris O on October 25, 2014, at 0:47:23
Seems like a tease to me. As they also cause so many side effects that effect GI, & heart. Phillipa
Posted by SLS on October 26, 2014, at 15:39:31
In reply to Anti-Inflammatory's May Help Depression, posted by Phillipa on October 22, 2014, at 9:49:45
If you are interested in brain inflammation specifically, I suggest researching minocycline. In addition to its antibiotic properties, it also suppresses microglial release of pro-inflammatory cytokines. Minocycline is also neuroprotective via its ability to reduce glutatergic hyperactivity.
It is very important to take vitamin C (ascorbic acid) 1000 - 2000 mg/day to help prevent the hyperpigmentation that can emerge at any time during minocycline treatment.
It has been suggested that combining minocycline with another antiglumatergic, lamotrigine, will produce a more robust effect.
- Scott
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