Do anti-inflammatory drugs make practical improvements in one’s mental health?
- Seung Hyun
- Dec 25, 2022
- 4 min read
Updated: Feb 18, 2023
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In our life, we always take medicine including not only antibiotics and anticancer drugs but also other nutritional supplement drugs. In the modern day, without some exceptions like addictive, narcotic drugs, people are very easy to purchase and take medicines. This pharmaceutical industry rapidly improved thanks to our infinite technological development, and the Covid-19 global pandemic well represents this improvement: a plentiful number of vaccines can be produced thanks to highly developed genetic modification technology. These medicines are developed for their specific purpose. For example, Ampicillin, a common antibiotic in our life, is produced to kill Enterococci. As such an instance suggests, a certain drug must provide an expected, specific treatment to the target disease. However, we can often see that a drug sometimes shows an unexpected result: one drug provides treatment for another one. In the same way, our anti-inflammatory drugs have a surprising result: a research study discovered that they can treat not only chronic inflammations but also depressive mental illnesses. Before exploring this unpredicted phenomenon, Let us dig deep into fundamental concepts.
What is an anti-inflammatory drug?
An anti-inflammatory drug is an agent that alleviates the inflammation itself and its overall symptoms and further spreads to our body. Inflammation is a process by which our immune system automatically responds to an invader, resulting in pain on the part of the body where the inflammation exists. Therefore, by mitigating the inflammation through the anti-inflammatory agent, patients would no longer feel pain.
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A mechanism by which our anti-inflammatory drug treats those symptoms is seemingly simple. Firstly, this agent can inhibit the enzyme cyclooxygenase, a protein to produce prostaglandins (a substance that causes inflammation in our body). This process can be triggered by competitive inhibition using an artificial molecule that has a similar structure that can bind to the active site of this enzyme, instead of the original messenger or noncompetitive inhibition using a substance that will bind to an allosteric site, modifying the overall shape of the enzyme. Furthermore, new research included that there are two cyclooxygenase isoenzymes: COX-1 and COX-2. This research found that COX-1 can protect our stomach from external damage, but COX-2 produces prostaglandins that will cause inflammation. Therefore, the researchers draw a conclusion that selective inhibition of COX-2 enzymes is required when synthesizing the anti-inflammatory drug without any side effects.
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Specifically, common NSAIDs are great instances of this process. Aspirin and Ibuprofen are agents that can inhibit both COX-1 and COX-2, but Celecoxib can inhibit only COX-2 enzymes, resulting in no damage to the stomach.
What is depression?
Depression is a mood disorder in which patients would suffer from disrupted feelings, logical thinking, and daily life like eating and sleeping. It is commonly distinguished into several types: major depression, persistent depressive disorder, perinatal depression, seasonal affective disorder, and depression with symptoms of psychosis. Those types of a disorder are divided by the specific circumstances of patients. Furthermore, people who suffer from bipolar disorder can experience similar kinds of depressive symptoms; however, the main difference between depression and bipolar disorder is that individuals who have bipolar disorder also suffer a sudden marked increase in activity level.
A common treatment for depression is medication. The first step of medication treatment is selective serotonin reuptake inhibitors (SSRIs). Doctors often start to prescribe this medicine because it causes fewer side effects than other medications. Then, the other medicines are Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs are duloxetine and venlafaxine. These types of antidepressants do not relate to addictive behaviors but physical dependence; therefore, they must not abruptly cease to take the medication, even worsening symptoms of depression.
How does an anti-inflammatory agent treat depression?
Back to the main point, recent research found that an anti-inflammatory drug can treat depression. According to the department of Psychiatry at the University of Cambridge, anti-inflammatory drugs work as antidepressants. When our body is exposed to infections from external circumstances, our immune system begins fighting off the infections. In the process of systemic inflammation, our immune cells are spread with cytokine through the bloodstream. This inflammation is marked as a degree of infection in our body: when our body is infected, this inflammation will rapidly increase. At this point, researchers found that this marked inflammation increases as people have mental disorders. Therefore, they concluded that since an anti-inflammatory drug decreases the marked level of systemic inflammation, it would lead to a decrease in the source of mental disorders including depression.
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Even though this research confidently finds the correlation between inflammation and depressive mental diseases, Golam Khandaker, a professor who leads a research pertaining to the relationship between anti-inflammatory drugs and depression, analyzed that only some patients can be treated with this drug, and the agents that can mitigate depression are different with common anti-inflammatory drugs such as Ibuprofen. Moreover, Peter Johnes, a co-author of the following research, was concerned that it’s too early to conclude that anti-inflammatory medicines have an apparent effect on alleviating depression. Moreover, they have no exact evidence to support that this method has no severe side effects and must conduct further research on patients who do not have chronic inflammatory symptoms. In conclusion, they must continue a more definite, systematic examination of its mechanism and wide application.
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