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Depressive psychosis associated with a cyclo oxygenase 2 inhibitor (meloxicam)

Published online by Cambridge University Press:  13 June 2014

Daniel White  and
MacDara McCauley
Daniel White*
Affiliation:
St Brigid's Hospital, Ardee, County Louth
MacDara McCauley
Affiliation:
St Brigid's Hospital, Ardee, County Louth, Ireland
*
*Correspondence E-mail: [email protected]
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Abstract

We describe a 60 year old man who developed a fluctuating depressive psychosis associated with meloxicam, a non-steroidal anti-inflammatory drug (NSAID). The psychological symptoms observed were temporally related to the administration of meloxicam and occurred in the presence of signs of meloxicam intolerance, such as skin rash and raised blood pressure. The depressive reaction resolved quickly following cessation of meloxicam, recurring on re-exposure. The psychiatric manifestations of NSAID intolerance are rare, however 40% of cases have a history of mental illness. Data from adverse event reporting systems suggest that the newer NSAIDs (COX-2 inhibitors) may have a higher propensity to cause psychiatric adverse effects and should be used with caution in individuals with a history of mental illness. This data may be provocative given current research in to the use of COX-2 inhibitors in augmenting neuroleptic treatment in schizophrenia.

Keywords

MeloxicamCOX-2 inhibitorNSAIDsAffective disordersSubstance-inducedAdverse effects
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 3 , September 2010 , pp. 157 - 158
Copyright
Copyright © Cambridge University Press 2010

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