Can Depression Be Treated With a Daily Baby Aspirin?
In this occasional feature on Psych Congress Network, members of the Psych Congress Steering Committee answer questions asked by audience members at Psych Congress meetings.
QUESTION: Would you suggest baby aspirin daily for our depressed patients? Why or why not?
ANSWER: This is probably the most important question currently facing those of us interested in the link between depression and inflammation. And the short answer is “No!” I say this based on several studies that have shown anti-inflammatory agents only benefit depressed patients who have elevated inflammation.
More than this, giving anti-inflammatories to all depressed patients willy-nilly isn’t just useless—it is actually counterproductive. Several studies now show that depressed patients with low levels of inflammation actually do worse when given an anti-inflammatory than when given a placebo.
So, I would not consider giving an anti-inflammatory agent to a depressed person without first measuring C-reactive protein (CRP), which is a good general marker for inflammatory status. For people with CRP levels above 5 mg/L, adding an anti-inflammatory may well help their depressive symptoms. This effect would perhaps extend down to a CRP level of 3 mg/L, although the data are not as strong for benefit at this level.
Now, having said all this, I need to clarify that low dose aspirin has many biological effects not related to inflammation (for example, effects on platelets as well as second messenger systems in the brain). To my knowledge, no one has rigorously studied whether these effects might confer benefits for depression that are unrelated to the anti-inflammatory effects of aspirin.
— Psych Congress cochair Charles Raison, MD, the Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families and Professor, School of Human Ecology, and Professor, Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison.
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