Antidepressants: OK for RA?

What you should know if your doctor recommends antidepressants in
addition to your prescribed RA treatments.
By Susan Bernstein

If your doctor diagnoses you with either depression or anxiety, you may
be prescribed one of the many drugs on the market designed to block or
regulate brain chemicals that may be at the root of these mood

Commonly prescribed antidepressants include:

Selective serotonin reuptake inhibitors (SSRIs): Fluoxetine (Prozac),
paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro)
Serotonin-norepinephrine reuptake inhibitors (SNRIs): Duloxetine
(Cymbalta), venlafaxine (Effexor), milnacipran (Ixel), desvenlafaxine

Tricyclic antidepressants: Amitriptyline (Elavil, Endep)

Norepinephrine-dopamine reuptake inhibitors: Bupropion (Wellbutrin,

Antidepressants are used to treat not only depression, but anxiety,
chronic pain and sleep issues. In fact, doctors may prescribe
antidepressants for treating chronic pain caused by RA, or even sleep
problems, rather than for depression or anxiety.

The drugs' use for these symptoms in people with RA remains
controversial, as they may not be that effective in reducing RA pain.
Some studies suggest that antidepressants may even treat inflammation
itself, but this has not yet been determined.

Your rheumatologist may prescribe an antidepressant for you, or he may
refer you to a mental-health professional like a psychiatrist who will
prescribe these drugs.

For people with RA who are diagnosed with depression, adding an
antidepressant may help regulate their mood, make them feel better
emotionally, and even help them sleep better.

What should you know about adding an antidepressant to the drugs you're
already taking for RA?

SSRI antidepressants, when taken along with a nonsteroidal
anti-inflammatory drug like ibuprofen or naproxen, can increase internal
bleeding risk. In addition, these antidepressants, if taken over the
long term, have been linked to bone loss. People with RA who have taken
long-term corticosteroids like prednisone to control inflammation may
also be at higher risk for bone loss, so bone density testing and
monitoring may be important.

As with any new medication, it's important to discuss the possible side
effects or interactions with your rheumatologist. You'll also want to
track how effective the antidepressant is at reducing your depression or

Antidepressant drugs aren't the only tool you and your doctor can use to
treat your depression or anxiety:

Seek counseling. A mental-health professional like a therapist,
psychologist or psychiatrist can discuss how RA increases your stress or
causes you frustration or grief, and recommend ways to manage feelings
more effectively.

Talk it out. Join an arthritis self-management or support group to learn
coping techniques and feel that you're not alone in living with RA.

Get moving. Exercise is nature's mood lifter. Regular physical activity,
including exercises designed to improve range of motion (ROM), strength
and cardiovascular fitness, has been shown to relieve depression
symptoms by actually increasing levels of serotonin, dopamine,
norepinephrine and other mood-related brain chemicals. Arthritis
exercise classes or videos can help improve physical function and help
you do your daily tasks more easily, so you may feel less frustrated by
your RA.

Donna G.

1) Rejoice always, Pray continually, Give thanks in all circumstances,
For this is God's will for you in Christ Jesus. ( I Thessalonians
5:16-18 NIV )

2) It is not the mountain we conquer but ourselves.
- Edmund Hillary

3) ANGELS EXIST, but some times, since they don't all have wings, we
call them FRIENDS......