Kickas.org Forums Treatments, Drugs and Alternatives AS Pharmacy NSAIDs and depression

Does anyone here know from experience if nsaids can cause depression? I have been on etodolac 400mg extended release for about 4 months now. For the last couple of months I have had some pretty strong depression. I've always had a tendency to get down at times, but usually not too far and for not too long. Most of the time I'm upbeat and happy. Lately though, there are many nights (like tonight for example) where I'm sort of thinking at the back of my mind that it sure would be nice to just go to sleep and not ever wake up. I often stop and try to think of reasons why I am happy to be alive and can't really think of any, or things I am actively looking forward to or excited about in the near or far future and can't think of even one thing.

I hate feeling like this and just really can't pin it on anything other than maybe cumulative stress or the meds or both. Have been talking to my doc about it. We tried a couple of anti-depressents and neither one lasted more than 3 days, couldn't stomach them at all. Am planning to see a pyschiatrist soon to get their input on it, but just wondered if anyone here had experienced a noticeable change in depression with any nsaids.

not depression, but a few definitely made me feel fatigued, brain foggy, so can imagine that depression could happen, even if its not a symptom reported. i had edema (fluid retention) on a statin and the doctor, pharmacist, etc had never heard of that, couldn't find it written anywhere, but i had it, so anything is possible.

the best way i've found to determine if a drug is causing a symptom is to stop the drug. often times the onset is insidious, but the clearing up of the symptom is remarkable. can you stop the drug and see if the depression lifts? switch to something else instead.

there are a lot of nsaids out there. i'm on number 11 nsaid/cox2 inhibitor, and have been surprised how different they all are. my only issue is that it seems that the ones that work cause intolerable side effects and the ones that don't cause side effects don't seem very effective. but am surprised how much they vary. i always thought their mechanism was pretty similar, but guess not, need to do more reading.

hope you get this depression thing turned around.

if during the fall / winter months, maybe try a light box, depending on where you are and how much sunlight you are getting.

my first year up here, the sun did not appear the entire month of january. and not exactly depressed, but when the sun appeared one day in february, found myself nearly giddy in comparison.

so the next year, i bought that light box, and it does help if i'm feeling rather blah.

for me though it was a subtle thing.

don't know if its cause we've been getting more sun these last two winters (we have been) or its the vitamin D i'm now on. but i'm not having the seasonal blahs i was having before.

hope its something simple you can change, be it the meds or the seasonal changes or something simple.

also, how much pain are you in. its really hard for me to avoid depression when i'm in a great deal of pain. i feel blessed that i've never been suicidal. but there have been stretches where i understood it a bit better, during those times i just didn't care if i lived or died. but when i'm better, the will to live is very strong, losing that will to live is not fun. losing that zest for life and living is not fun.

hope the psychiatrist helps you get to the bottom of it. and hopefully not just by adding another drug, unless that's what it takes.

I am sure that the time of year isn't helping anything as I usually notice my moods not being as bright and happy during January/February. But this year it has been much different, much stronger than in the past. In the past even at my worst I still had a sense of optimism that it would blow over soon and not be a big deal. Lately, I've not been optimistic at all. Pain levels vary from day to day. I just started enbrel last week, so I am really hoping it helps. Also started percocet last week as well and I simply take them when I need them. Had previously used Tylenol 3 but they just were not effective enough.

My wife is really pushing me to go see the pyschiatrist, but I am hesitant because I am afraid its gonna be another pill to take and I don't want to have to take any pills at all. I am hoping that some basic counseling will be sufficient as I am reluctant to agree to taking any new meds.

though a light box probably won't cure all, it could be a helpful addition, not the only thing, but one of the things.

also i did read recently that vitamin D may be helpful, if you're not taking it, or yours is low, that could be worth a try as well. once i get mine up to where it should be (when my body doesn't digest its food it drops), i'll try taking 1000- 3000 IU a day, whatever it takes to maintain it.

if you just started the enbrel, then maybe you will be able to drop the nsaid. then you can at least tell if its the nsaid. that would be nice if that's the main culprit and you don't need it anymore.

as for the psychiatrist, maybe try a psychologist, someone to talk to vs just another med. or find a doctor who is more into talking, less into drugs as the first course of action. like with any doctor, some GPs want to throw statins at bad cholesterol without considering diet/exercise first, others use the drugs as the last resort. so maybe ask around and find someone with a philosophy that coincides more with yours. seeing a professional never hurts and we don't have to take the medications just because the doctor tells us to, its up to us, though working with someone with a similar mindset makes for a better team.

and if your wife thinks you should go, you probably should. i know how easy it is to get bogged down within myself and really its the people around us that can see most clearly what we are going through, at least its that way with me and my husband. i use him as my sounding board constantly.

so i say go, but maybe see if meds for depression can be a last resort after trying other things first.

here's to happier days!

Depression is very common with AS. I have had it off and on. If you would rather not take any medications, then maybe you could try the no starch diet. I ended up taking lactose and sugar out of my diet too, but it was so worth it. It took my pain and stiffness down from a 10 to a 1. That way you could tell if it was the meds, or seasonal depression maybe, or just the huge amount that weights on our minds everyday because we have this crazy disease. There is a tanning bed that does not tan you, it just emits safe rays that generate vitamin D in your skin. That is supposed to be quite effective at fighting seasonal depression (so says the phlebotomist at my Docs office, lol).

If you want to know more about the diet, there is a NSD forum and it has loads of info.

Good luck to you. Depression is a hard deal for sure. I remember thinking, "I have a good life, my husband does not beat me, my kids are good, WHAT is wrong with me?" But if you take "you" out of the equation and just realize that your chemicals are out of balance or your vit D is too low, then you can kind of avoid blaming yourself. "This too shall pass."

Soft hugs,
Donette

Hi txfast,

Yes.

'Some' nsaids can cause depression as a less common side effect. I only know this from an experience I had a couple of decades ago, when I was first starting on an anti-inflammatory and trying to find one that suited me. I am not prone to depression and had no experience with it, so I didn't even recognise what was going on for a few months. (Otherwise the nsaid was working well for my AS.) I can't remember which one it was now, Indomethacin or Naprosyn, I think.

I figured it out by questioning my pharmacist on whether it was possible and they looked it up for me. It wasn't on their standard list of side-effects but they had additional big book of information that indicated it could be responsible, and sure enough, when I stopped the med that side effect disappeared. My rheumatologist gave me another prescription to try and it was such a relief! Pharmacists can be a very useful source of reliable information and are usually very happy to help.

I'd call your pharmacist and see what info they might be able to provide. If it is a side effect in your case, it isn't one that you should try to tolerate. Don't give up in looking for the right med, or combo of treatments to help. It can take some time to hit on what suits us the best.

Hang in there!
mig