July 23, 2015
Antidepressants and NSAIDs:
A Dangerous Combo

The combination of antidepressants and nonsteroidal anti-inflammatory drugs (NSAIDS) is linked to an early increased risk for intracranial hemorrhage, regardless of the type of NSAID or antidepressant, new research shows.

For the retrospective study, researchers analyzed data from the Korean nationwide health insurance database of 4,145,226 people who were treated with antidepressants with and without NSAIDs. In looking at the main outcome measure of time to the first hospital admission with intracranial hemorrhage within 30 days of drug use after controlling for factors that included warfarin and steroid use and dementia, the investigators found a significantly higher risk for intracranial hemorrhage during that 30-day period among patients treated with a combination of antidepressants and NSAIDs compared with those receiving antidepressants without NSAIDs.

There were no significant differences in the increased intracranial hemorrhage risk between the antidepressant classes of serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors, or tricyclic antidepressants.

Stewart W. Mercer, PhD, of the University of Glasgow, in the United Kingdom, and colleagues with the University of Cambridge, UK, noted that the findings are of particular concern because of the high number of patients who commonly use both types of drugs. "Most worryingly, conditions requiring NSAIDs and antidepressants commonly coexist; 65% of adults with major depression also have chronic pain, with both morbidities sharing common psychological risk factors and neurobiological processes," they write.

According to the Center for Disease Control and Prevention, 11% of Americans take antidepressant medication. From 1988-2008, the rate of antidepressant use in the United States increased nearly 400%. More than 70 million prescriptions for NSAIDs are written each year in the United States. With over-the-counter use included, more than 30 billion doses of NSAIDs are consumed annually in the United States alone.

With so many Americans currently using antidepressant therapies, and the numbers using NSAIDS in the billions, the chances of our patients taking both is high. In our patients with depression and chronic pain, are there other options?

Testing to identify neurotransmitter imbalances and then addressing them with amino acid precursors and appropriate cofactors may prove to be a safer way of treating depression and chronic pain.

Interested in learning more about identifying and treating neurotransmitter imbalances? Join Labrix on August 1 at Labrix Core Training in Portland, OR and learn more about common symptom patterns, test result interpretation and treatment options for patients suffering from chronic pain, depression, anxiety and more. 6.75 CE's available for NDs, accredited by the Oregon Board of Naturopathic Physicians. Space is limited. Click here to reserve your seat at Core Training today!

  • Melville, Nancy. Antidepressant/NSAID Combo Linked to Brain Bleed Risk. http://www.medscape.com/viewarticle/848016?src=wnl_edit_medn_wir&uac=122675SY&spon=34&impID=763735&faf=1. Accessibility verified 7/20/15.
  • Mercer SW, Payne RA, Nicholl BI, Morrison J. Risk of intracranial haemorrhage linked to co-treatment with antidepressants and NSAIDs. BMJ 2015 Jul 14; 351:h3745. doi: 10.1136/bmj.h3745.
  • NCHS Data Brief. Number 76, October 2011. Antidepressant Use in Persons Aged 12 and Over: United States, 2005-2008. http://www.cdc.gov/nchs/data/databriefs/db76.htm. Accessibility verified 7/20/15.
  • Wiegand TJ. Nonsteroidal Anti-inflammatory Agent Toxicity. http://emedicine.medscape.com/article/816117-overview. Accessibility verified 7/20/15.

Labrix Clinical Spotlight Series:
Adrenal Health

Staff physician Krista Anderson-Ross discusses the role of the hormone cortisol and how it relates to stress, symptoms of adrenal imbalance and treatment options, as well as other topics regarding adrenal health.

Core Training
Portland, OR
August 1, 2015

Labrix staff physicians will be in Portland on August 1 to present Core Training. Registration is $150 and upon completing this one day training, you will receive a $100 credit on your testing account. Register for Labrix Core Training: Portland today.

Advanced Workshop
Las Vegas, NV
January 16-17, 2016

Join Labrix founders and staff physicians for 2 full days of training and case studies, focusing on hormone, adrenal and neurotransmitter optimization. The workshop is just $199: Register today!

Greenville, SC
September 26-27, 2015

Labrix co-founder Jay Mead, MD will be speaking at the American Academy of Thermology conference, September 26-27, 2015. Dr. Mead will be presenting on scientific updates regarding hormone testing.