Antidepressants and pain killers: should we be worried?

New research has identified an increased risk of brain haemorrhage from the combined use of antidepressant medicines and medicines such as ibuprofen. Should we be worried? Dr Rupert Payne from the Cambridge Centre for Health Services Research looks at the evidence.

 

If people are worried about the medications they are taking, they should discuss their concerns with their doctor.
   - Rupert Payne

Many of us frequently take pain killers to relieve our headaches, to soften joint pains or to reduce the symptoms of a cold. Some of these drugs – for example, ibuprofen, but not paracetamol – are from a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). These medicines are very commonly used – in fact, they are among the top 20 most frequently prescribed medications in UK primary care. Non-prescription use is also widespread, with many products available off the shelf in supermarkets and without oversight from a pharmacist.

Antidepressants medication use is also commonplace, although in the UK these are prescription only medicines. Importantly, depression and chronic pain frequently co-exist: roughly a third of those with a painful condition also experience depression, and over a quarter of those suffering depression also complain of pain.

A paper out this week in the BMJ has identified an increased risk of brain haemorrhage from the combined use of antidepressants and NSAIDS. This will understandably raise concerns among both doctors and the public. But is it that straightforward?


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Image:Pills here (cropped)
Credit: Robson#


Reproduced courtesy of the University of Cambridge
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