Some of your customers could find relief from depression in the OTC and supplement aisles. According to a study published October 28 in the Journal of Neurology Neurosurgery & Psychiatry, aspirin, ibuprofen, and fish oil can reduce the symptoms of major depression. So can other anti-inflammatories, such as statins and antibiotics.
A simple, accessible, and inexpensive therapy could be good news for millions of people who suffer from depression. About 30% of patients with depression find no relief from prescription antidepressants or psychotherapy. Others relapse and some stop the medications because of intolerable side effects or cost concerns.
The role of inflammation in depression and many other illnesses has been a hot topic for researchers in recent years. Observational studies have found high levels of inflammatory markers such as interleukin-6, interleukin-2 receptor, C-reactive protein, and tumor necrosis factor-alpha in patients with depression and a reduction in markers associated with improvement in symptoms. A number of clinical trials have looked at the potential for anti-inflammatory therapy to ameliorate depression, with mixed results.
The meta-analysis pooled the data from 31 randomized clinical trials conducted through January 1, 2019 that compared anti-inflammatories with placebo. Twenty-six of the studies measured improvement on a depression scale. The anti-inflammatories included nonsteroidal anti-inflammatory drugs (NSAIDs), omega-3 fatty acids, cytokine inhibitors, statins, corticosteroids, minocycline, pioglitazone, modafinil, and N-acetyl cysteine (NAC). The studies enrolled a total of 1,610 participants diagnosed with major depressive disorder.
The pooled analysis found that the anti-inflammatories significantly reduced depressive symptoms. Overall, the anti-inflammatories proved 52% more effective in relieving symptoms and 79% more effective at banishing symptoms than placebo.
Participants saw a benefit from both monotherapy with the anti-inflammatories and from adding them to existing antidepressant therapy, based on subgroup analysis. Adjunctive therapy showed greater reduction in symptoms than the anti-inflammatories alone. Notably, neither sponsor type nor study quality affected the outcomes.
Drilling down, the researchers identified that the greatest response came from NSAIDs, omega-3 fatty acids, statins, and minocyclines, although they noted that just three studies examined statins and minocyclines.
One study reported an allergic reaction—rashes and itching—to fish oil and one reported four serious adverse events associated with NAC, though that study also reported five serious adverse events for placebo. None of the other studies reported serious adverse events. Gastrointestinal adverse events occurred at higher rates in the statin and NAC groups, and patients in the modafinil group had more psychiatric adverse events than those in the placebo group.
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