Arthritis Medication Increases Antidepressant Drug Effectiveness

When given to the severely depressed patients, arthritis drug Celebrex (celecoxib) drastically increased the effectiveness of the antidepressant medications, according to a Loyola study. It was reported by a leading Loyola Medicine psychiatrist Angelos Halaris, who presented the research at the V International Congress of Psychiatry and Neuroscience in Athens (Greece). Dr. Angelos Halaris is a professor in the Department of Psychiatry and Neuroscience of Behavior of the University of Loyola at the Chicago Medical School.

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The eight-week study was conducted in bipolar adults, 18 to 65 years of age, who were in the depressive phase of their disease and had not benefited from an antidepressant. Bipolar disorder is characterized by alternating periods of exaltation and depression.Patients were randomly assigned to receive the antidepressant Escitalopram (Lexapro) plus Celecoxib or Lexapro, plus a placebo.

Seventy-eight percent of patients in the Celecoxib group experienced a reduction of at least 50 percent in their depression scores, with 63 percent reporting that their depression had disappeared entirely. In comparison, only 45 percent of the placebo group reported a reduction of 50 percent or more in depression, with only 10 percent reported that their depression was fully eradicated.

It typically takes four to six weeks before any antidepressant starts working. In the Loyola study, patients on Celecoxib began to see benefits from their antidepressant in one week. Fifty-five patients completed the study: 31 in the Lexapro plus Celecoxib group and 24 in the Lexapro plus placebo group.

Previous studies have found that depression disrupts the immune system causing chronic inflammation. This inflammatory response alters the normal balance of chemical messengers in the brain called neurotransmitters. Inflammation hinders the function of antidepressants designed to restore normal chemical balance. By combating inflammation, Celecoxib appears to make antidepressants more effective, Halaris said.

Celecoxib is used to treat pain, redness, inflammation, and arthritis. It can also handle acute pain and menstrual cramps. It does not address depression by itself.

The study findings support the hypothesis that inflammation plays a critical role in depression. Reducing inflammation with a drug such as Celecoxib “reverses treatment resistance and improves overall antidepressant response,” Dr. Halaris wrote in the study. “Such treatments, if implemented relatively early in the course of the disease, can stop the neuroprogressive course of bipolar disorder.”

Dr. Halaris’s study “Controlling Inflammation Invests Resistance to Treatment in Bipolar Depression” was presented at the International Congress of Psychiatry and the Neuroscience meeting.