This post was originally published on August 28, 2015.
Chronic pain is a bitch. The people I know who suffer from it are usually, and quite understandably, irritable and depressed. And clinical depression can be so debilitating that you also feel physically ill. In fact, according to Harvard Medical School, those with chronic pain conditions are three times as likely to develop psychiatric disorders and, in turn, those experiencing severe depression are three times as likely to develop chronic pain issues. So which came first, the sad chicken or the cracked egg?
Big Pharma to the Rescue?
Chronic pain and depression are intimately interwoven—which is why it’s especially disturbing that a team of researchers from South Korea has found there is an increased risk of brain bleeding, or “intracranial hemorrhage,” when a person takes both a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen and an antidepressant.
Both types of medication, when taken on their own, have been shown to increase the risk of gastrointestinal bleeding, but it’s the combination of the two that apparently raises the possibility of intracranial bleeding. The findings were reported last month in the journal The BMJ.
“Compared with the use of antidepressants alone, the combined use of antidepressants and NSAIDs was associated with an increased risk of intracranial hemorrhage,” the study concludes.
Granted, the research looked only at prescription NSAIDs, which patients may take in higher doses than their over-the-counter versions. But the words “brain bleed” in conjunction with anything are still hair-raising.
Depressed Koreans Helping Science
Conducted by a team at Seoul National University College of Medicine, the study analyzed data from a sample of four million-plus Koreans who began using antidepressants between 2009 and 2013, half of whom were also prescribed an NSAID. The researchers checked hospital records to see who was admitted for brain bleeding within a month of starting the painkiller.
They retrieved their data from the Korean Health Insurance Review and Assessment Service. All Koreans are covered by the country’s National Health Insurance program so the database contains all information on the drugs prescribed to approximately 50 million people. If you live in South Korea, The Man may know about your Celexa ‘script. My immediate thought when reading how they got their information was how much more complicated research like this would be in the US with its strict medical privacy laws. Luckily for medicine, the personal details of Korean citizens are up for public consumption.
Men at More Risk
Anyway, the researchers concluded that people taking both types of medication were at a 60 percent higher risk for brain bleeding. And interestingly enough, men’s risk proved to be greater than women’s. For women who took both anti-depressants and NSAIDs, the risk was 1.2 times higher and, for men, it was 2.6 times higher.
As a Forbes writer points out, these findings are only based on incidents that occurred within four weeks of taking both types of meds. We don’t know how dangerous the long-term side effects are or how the effect of over-the-counter painkillers may differ from prescription. But this research is certainly something to consider when talking to a doctor about psych meds and painkillers. The double whammy of chronic pain and raging depression is no picnic but “up my chances for a brain hemorrhage” wouldn’t be on my to-do list either.
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