Over-the-Counter Pain Medicines Interfere with Antidepressants

Acetaminophen and NSAIDs disrupt SSRIs

(RxWiki News) Millions of people rely on antidepressants to keep the blues away. A new study has found that popular over-the-counter pain relievers can reduce the effectiveness of specific antidepressants.

Recent research has found that acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Motrin) can interfere with  serotonin reuptake inhibitors (SSRIs), making them less effective.

"Over-the-counter pain meds can decrease effectiveness of antidepressants."

For this study, investigators analyzed findings from the seven-year Sequenced Treatment Alternatives to Pain Relieve Depression (STAR*D) study, which looked at depression treatment in 4,041 outpatients between the ages of 18 and 75 years old.

Less than half of the STAR*D participants (45 percent) who took SSRI and a pain medication had complete relief of their depression symptoms. This compares to 55 percent of participants who were not taking a pain reliever along with an SSRI.

While the exact reason for this is not known, animal studies have suggested that the painkillers interfere with the brain chemicals that SSRIs treat.

"This study illustrates the importance of telling your doctor about all medications you're taking on a regular basis," said Russell Ricci, MD, Chair of dailyRx's Medical Advisory Board.  "We are constantly learning that even over-the-counter medicines and even herbs can interfere with prescription medications and other drug therapies."

People who aren't receiving full benefit from their SSRIs may want to slow down their use of over-the-counter pain relievers or switch to a different kind of antidepressant, says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter.

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Review Date: 
September 1, 2011