Aspirin, a well-known pain reliever and anti-inflammatory drug, has been a staple in medicine cabinets for decades. Commonly used to relieve pain, reduce fever, and lower inflammation, it’s a versatile over-the-counter medication. But beyond its well-known uses, there’s been growing interest in whether aspirin could play a role in treating depression. Let’s delve into the research to understand whether aspirin might have potential benefits for individuals struggling with this mental health condition.
What Is Aspirin?
Aspirin, or acetylsalicylic acid, is a nonsteroidal anti-inflammatory drug (NSAID). It works by inhibiting cyclooxygenases (COX), enzymes that produce prostaglandins—compounds involved in inflammation, pain, and fever. By lowering prostaglandin levels, aspirin effectively reduces inflammation and alleviates pain.
The Link Between Inflammation and Depression
Emerging research has highlighted a potential connection between inflammation and depression. In fact, there’s a growing body of evidence suggesting that inflammation may play a role in certain types of depression. Elevated levels of inflammatory markers, such as cytokines, have been observed in individuals with depression. While not all forms of depression are associated with inflammation, research suggests an inflammatory subtype may exist, and some people with depression have elevated inflammatory markers.
Can Aspirin Help with Depression?
Given aspirin’s anti-inflammatory properties, researchers have explored its potential to alleviate depressive symptoms, particularly in individuals with high levels of inflammation. A noteworthy study published in JAMA Psychiatry examined the use of anti-inflammatory agents, including aspirin, in treating depression. The review found that anti-inflammatory agents, mostly the NSAID celecoxib in small trials, showed some promise in reducing depressive symptoms, but the evidence is mixed. A large randomized trial published in 2020 found that daily low-dose aspirin did not prevent depression in older adults.
The Risks of Aspirin as a Depression Treatment
While the research is interesting, it’s important to recognize that aspirin is not a benign, side-effect-free treatment. As an NSAID, aspirin can cause gastrointestinal (GI) issues, particularly with prolonged or high-dose use. It can damage the stomach lining and the small intestine, leading to ulcers and bleeding, and taking aspirin together with an SSRI or SNRI antidepressant raises the risk of bleeding further. This damage is partly due to changes in the gut microbiome, which can be harmful to overall health.
Interestingly, there’s research suggesting that probiotics, such as Bifidobacterium breve, might help mitigate some of the GI damage caused by aspirin. However, these probiotics do not completely prevent the harm, making aspirin a less-than-ideal long-term solution for managing depression.
Alternative Anti-Inflammatory Treatments for Depression
Given the potential risks associated with aspirin, it may be wiser to consider other anti-inflammatory treatments that do not carry the same risks. Lifestyle changes, such as adopting an anti-inflammatory diet, incorporating exercise, and managing stress, may help reduce inflammation. Supplements like fish oil and turmeric are also being studied, but they carry their own risks: turmeric or curcumin supplements can affect the liver and interact with blood thinners. Check with your clinician before starting any supplement, especially if you take psychiatric medication, are pregnant or breastfeeding.
The Bottom Line
While some anti-inflammatory agents have shown early potential in treating depression, particularly in individuals with high inflammation, they are not without risks. Aspirin, in particular, can cause significant gastrointestinal damage, which may outweigh its benefits as a depression treatment. Therefore, it’s crucial to consult with a healthcare professional before adding aspirin to your treatment regimen. Do not start aspirin for mood without talking to your prescriber. They can help you weigh the risks and benefits and explore other options for managing depression and inflammation.
Ultimately, depression is a complex condition that requires a comprehensive treatment plan. This plan might include therapy, lifestyle changes, medications, and other interventions tailored to the individual’s needs. While aspirin may be a part of this plan for some, it’s just one piece of the puzzle in the broader context of mental health care.
References
1. Miller, A. H., & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews Immunology, 16(1), 22-34.
2. Khandaker, G. M., Dantzer, R., & Jones, P. B. (2017). Immunopsychiatry: important facts. Psychological Medicine, 47(2), 222-234.
3. Köhler, O., Benros, M. E., Nordentoft, M., Farkouh, M. E., Iyengar, R. L., Mors, O., & Krogh, J. (2014). Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry, 71(12), 1381-1391.
4. Akhondzadeh, S., Jafari, S., Raisi, F., Nasehi, A. A., Ghoreishi, A., Salehi, B., … & Kamalipour, A. (2009). Clinical trial of adjunctive celecoxib treatment in patients with major depression: a double blind and placebo controlled trial. Depression and Anxiety, 26(7), 607-611.
5. Mortensen B, Murphy C, O’Grady J, Lucey M, Elsafi G, Barry L, et al. Bifidobacterium breve Bif195 protects against small-intestinal damage caused by acetylsalicylic acid in healthy volunteers. Gastroenterology. 2019; 157: 637–646.
