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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by mtom on April 25, 2019, at 9:33:19
This ties in with my previous post about depression as an autoimmune disease (i.e. the "inflammatory" theory of depression).
A few studies re using NSAIDS to treat depression:
https://www.loyolamedicine.org/news/arthritis-drug-effectiveness-antidepressant
https://www.ncbi.nlm.nih.gov/pubmed/28953795
https://www.nature.com/articles/4001805
https://www.amjmed.com/article/S0002-9343(13)00358-6/fulltext
Note: Some focussed specifically on the Cox-2 inhibitor celecobix
Posted by Lamdage22 on April 25, 2019, at 10:50:32
In reply to Studies:NSAIDS for depression (inflammation theory, posted by mtom on April 25, 2019, at 9:33:19
Well what can we do but hope that scientists pick up on this? Since society is more concerned with economic growth rather than health or happiness, maybe they wont.
Posted by Lamdage22 on April 25, 2019, at 10:57:32
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by Lamdage22 on April 25, 2019, at 10:50:32
They are sending people to the moon, but they fail to help a lot of diseased people and prevent human suffering.
Posted by Lamdage22 on April 25, 2019, at 10:59:47
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by Lamdage22 on April 25, 2019, at 10:57:32
Many people go to the Dr and come back even sicker than they were before. And yet no one seems to care! Its good business!
Posted by linkadge on April 25, 2019, at 16:42:35
In reply to Studies:NSAIDS for depression (inflammation theory, posted by mtom on April 25, 2019, at 9:33:19
The good news is that it is pretty easy to test the theory (i.e. to see if your depression is responsive to a reduction in inflammation).
You can see if your mood responds to anti-inflammatory medications. I would caution against aspirin (unless doctor supervised) since SSRIs and aspirin can synergistically thin the blood.
The omega-3s have significant anti-inflamatory effects and have been shown to augment standard anti-depressant medications. Diet can reduce inflamation too, i.e. reduce sugar, eat inflamation reducing foods.
Linkadge
Posted by mtom on April 26, 2019, at 8:36:06
In reply to Re: Studies:NSAIDS for depression (inflammation theory » mtom, posted by linkadge on April 25, 2019, at 16:42:35
Most of the studies seemed to find Celecobix (Celebrex) was most effective. This is available only by prescription and most doctors might be reluctant to prescribe it as an antidepressant add-on, unless you show them the studies. Some studies it was given to people who had co-existing arthritis with depression. Some recommend testing for inflammation first, e.g. C-Reactive Protein. The Loyola study comments that other studies have found Celecobix beneficial as an add-on in doses up to 400 mg (my Dr won't prescribe more than 200). It does not say what dose Loyola used, it was also as an add on to escitalopram, and the study seem to be still in progress with "preliminary" results being reported so far: go to https://www.researchgate.net/publication/275115059_90_Inflammation_control_augments_antidepressant_response_in_bipolar_depression and click on Download PDF.
Many Doctors are still reluctant to prescribe Celecobix due to the Vioxx fiasco several years ago when Vioxx was pulled off the market. Because Celecobix is also a Cox-2 Inhibitor, it was presumed to have similar side effects - and doctors seem to prefer to prescribe Naproxen or Advil. However there have been several recent studies showing celecobix appears to in fact be safer than either Naproxen or Advil for GI, Cardiac and Kidney, and does not have the serious side effects of Vioxx.
I am also taking Omega-3's, eat very little sugar, and have been making sure to eat anti-inflammatory foods daily e.g. leafy greens, crucifers, blueberries, extra virgin olive oil, Turmeric, etc. and trying to avoid inflammatory foods e.g. deep fried, soy oil, and buy organic and naturally raised to the extent possible (not always a good variety available in Canada). Also trying to avoid gluten, difficult especially at social occasions. Eating more seafood.
I am also micro-dosing with CBD Oil, prescribed by a Doctor and provided by Government regulated and licensed Medical Cannabis producers here in Canada). Still take low dose escitalopram, without much beneficial effect and some side-effects continue. Hoping to wean off this at some point. Other AD's tried were worse.
Expect it could take a few months to notice any difference from all these, will see how it goes.
> The good news is that it is pretty easy to test the theory (i.e. to see if your depression is responsive to a reduction in inflammation).
>
> You can see if your mood responds to anti-inflammatory medications. I would caution against aspirin (unless doctor supervised) since SSRIs and aspirin can synergistically thin the blood.
>
> The omega-3s have significant anti-inflamatory effects and have been shown to augment standard anti-depressant medications. Diet can reduce inflamation too, i.e. reduce sugar, eat inflamation reducing foods.
>
> Linkadge
>
>
Posted by linkadge on April 26, 2019, at 16:24:17
In reply to Re: Studies:NSAIDS for depression (inflammation theory » linkadge, posted by mtom on April 26, 2019, at 8:36:06
I also have a medical marijuana card (in Canada). I have used both CBD and THC selective oils as well as a combination. In terms of inflammation, the THC is much more potent. The anti-inflammatory effects of cannabanoids are mostly through an activation of the CB2 receptors (which are located on immune cells). Of course, THC can have additional psychoactive effects.
I use a (relatively balanced) CBD / THC product with good results. The CBD alone wasn't quite potent enough. Of course, this is an individual decision.
There is evidence that many NSAIDs work ultimately via cannabinoid mechanisms. COX enzymes inhibit the synthesis of endocannabinoids.
You are right that Celebrex is the most studied, but there have been other positive effects of other meds. Google 'aspirin and mood'. I wouldn't lament it if your doctor won't prescribe celecoxib. Like I said, you can add other anti-inflammatories to your regiment, (just to see if your mood improves). Anti-inflammatory likely don't improve all depressions. If you positively respond however, you could bring this anecdotal information to your doctor, to discuss how you might move forward.
Linkadge
Posted by Ruuudy on April 26, 2019, at 23:34:41
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by linkadge on April 26, 2019, at 16:24:17
I've discussed the Inflammation theory with my primary doctor and had the bloodwork that show that my levels are in check. Is it still possible that there could be undetectable inflammation occuring in the brain?
I'm starting to feel some arthritis as I age - maybe I can request some Celebrex!
Rudy
Posted by linkadge on April 27, 2019, at 6:47:16
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by Ruuudy on April 26, 2019, at 23:34:41
I believe it is possible for the brain to be in a state of high inflammation without necessarily having high markers of systemic inflammation. Often in depression / anxiety there is microglial activation, but this may not be best dealt with by taking NSAIDs. Also, there are many different immune cytokines that can become activated. There is likely not a complete overlap with conditions like arthritis. Keep in mind, drugs that aren't necessarily inflammation reducing can help lower brain inflammation. For example IL-1B is often elevated in depression / anxiety (at least in animal models). It decreases the brain's sensitivity to endocannabinoids. Green tea can apparently help normalize the levels of IL-1 when it is induced by stress. Minocycline (antibiotic) can also reduce microglial activation. You can google search "lowers il-1b" to get an idea of what may impact this inflammatory marker.
Linkadge
Posted by mtom on April 27, 2019, at 9:57:57
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by linkadge on April 27, 2019, at 6:47:16
There is lots discussion re dietary influences on inflammation. Podcasts and Articles by Functional Medicine Doctors, Integrative Health Doctors, Nutritionists, etc.
In particular they note sugar and starches increase inflammation. Also omega-6 fatty acids which, in modern times, the typical diet is overly high in - from seed oils (like soy, sunflower, etc - used in most processed foods & restaurants) and livestock fed grain based diets. Lowering omega 6 ratio in relation to omega 3 is important (as omega 6 interferes with omega 3 in the body).
Gluten sensitivity causing inflammation also increasingly talked about though still controversial.
I guess this is getting more into "alternative" rather than "medication" related......
Posted by linkadge on April 27, 2019, at 16:41:13
In reply to Also diet + inflammation (NSAIDS for depression), posted by mtom on April 27, 2019, at 9:57:57
Fasting lowers inflammation. Overeating probably increases it.
Posted by pedr on May 14, 2019, at 17:57:12
In reply to Re: Studies:NSAIDS for depression (inflammation theory, posted by Lamdage22 on April 25, 2019, at 10:57:32
> They are sending people to the moon, but they fail to help a lot of diseased people and prevent human suffering.
Amen brother, Amen.
This is the end of the thread.
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