Augmentation of Citalopram with Aspirin for Treating Major Depressive Disorder, a Double Blind Randomized Placebo Controlled Clinical Trial
Ahmad Ghanizadeh and Arvin Hedayati
Affiliation: Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital, Shiraz, Iran.
There are contradictory reports about the association of cytokines levels and major depressive disorder and the
possible therapeutic role of aspirin for treating major depressive disorder (MDD). A clinical sample of adult out-patients
with MDD was recruited. At recruitment, they were interviewed face to face according to DSM-IV diagnostic criteria. In
addition, Hamilton depression rating scale was completed by a psychiatrist. The patients were invited to receive aspirin or
placebo. All the 10 patients received 160mg/day aspirin plus citlaopram 20 mg/day. Eight out of ten patients showed severe
anxiety and akathesia from early days of this trial. Except for two patients, we discontinued the medication during 14
days of this trial. Three patients were hospitalized due to anxiety and akathesia. Two patients reported suicidal behavior
after the onset of this trial. This trial of aspirin adjuvant therapy for treating MDD suggests that this combination is not
safe and there are some serious and intolerable adverse effects. This finding is in contrast to the suggestions assuming that
aspirin may be effective for treating MDD. Aspirin may negatively impact on both pro- and anti-inflammatory cytokines
balance in depression. Aspirin may antagonize the antidepressant effect of citalopram.
Keywords: Anti-inflammatory agents, aspirin, depressive disorder, inflammation, NSAID, therapeutics, treatment outcome.
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