Arthritis Medication May Help Treat Depressive Symptoms

Previous research found that arthritis patients are more likely to experience anxiety and/or depression than the general population. And a recent study has found that anti-inflammatory medication—which is used to treat arthritis—could be beneficial for patients with depression.

“Our study shows that a combination of anti-inflammatory medicine, which is what arthritis medicine is, and antidepressants can have an additional beneficial effect on patients with a depression,” said study author Ole Köhler-Forsberg, a PhD student and medical doctor from Aarhus University and Aarhus University Hospital, Psychiatry, in a press release. “The effect was also present when anti-inflammatory medicine was compared with a placebo in patients with a physical disease and depressive symptoms.”

For the review, the team identified 36 randomized controlled trials (RCTs) published up until Jan. 1, 2018, that discussed antidepressant treatment effects and side effects of pharmacological anti-inflammatory intervention among patients with major depressive disorder (MDD) or depressive symptoms. The following outcomes were considered: depression scores after treatment, remission, response, and side effects.

Of the 36 RCTs, 13 analyzed nonsteroidal anti-inflammatory drugs (NSAIDs), totaling 4,242 patients: nine cytokine inhibitors (n = 3,345), seven statins (n = 1,576), three minocycline (n = 151), two pioglitazone (n = 77), and two glucocorticoids (n = 59). MDD patients experienced improvement in their symptoms when taking anti-inflammatory agents as an add-on (standardized mean difference [SMD] = −0.64; 95%‐CI = −0.88, −0.40; I2 = 51%; n = 597) or monotherapy (SMD = −0.41; 95%‐CI = −0.60, −0.22; I2 = 93%, n = 8825); anti-inflammatory as an add-on treatment also resulted in improved response (risk ratio [RR] = 1.76; 95%‐CI = 1.44–2.16; I2 = 16%; n = 341) and remission (RR = 2.14; 95%‐CI = 1.03–4.48; I2 = 57%; n = 270). The researchers also acknowledged a trend toward greater infection risk and noted that all studies had a high bias risk.

“We found a trend toward an increased risk for infections, and all studies showed high risk of bias,” the study authors noted.

The results also call for further research.

“We still need to clarify which patients will benefit from the medicine and the size of the doses they will require,” said Ole Köhler-Forsberg. “The findings are interesting, but patients should consult their doctor before initiating additional treatment.”

The Link Between Arthritis and Mental Health

An October 2018 report from the Centers for Disease Control and Prevention found that arthritis patients were more likely than the general population to suffer from symptoms of anxiety (22.5% versus 10.7%) or depression (12.1% versus 4.7%).

More adults with arthritis take medications to treat symptoms of depression than anxiety (57.7% [CI = 52.4–62.9] vs 44.3% [CI = 40.4–48.3], respectively). Patients with depressive symptoms were also more likely to report having spoken with a mental health professional in the past year than those with anxiety (42.8% [CI = 37.7–48.1] vs 34.3% [CI = 30.3–38.1], respectively).

Of patients with arthritis and chronic pain, 31.2% reported symptoms of anxiety, and 18.7% said they had depressive symptoms. Symptom prevalence was higher among those with co-occurring chronic conditions, psychological distress, and poor self-rated health.