Taking both antidepressants and common painkillers could increase a person's risk of bleeding inside the skull, a new study suggests.

Depression is a common mental health problem. However some doctors have expressed concern that antidepressants used to treat the condition may interact with commonly used painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), and increase the risk of bleeding inside the skull (intracranial haemorrhage).

NSAIDs include aspirin and ibuprofen.

Researchers in Korea decided to investigate this issue further by comparing the risk of bleeding among patients on antidepressants, some of whom used NSAIDs and some who did not.

Using a health database, they looked at over four million people who were prescribed antidepressants for the first time between 2009 and 2013.

Hospital records were used to identify anyone who had been admitted with an intracranial haemorrhage, and details on NSAID use were also assessed.

The study found that when compared with the use of antidepressants alone, combining antidepressants and NSAIDs substantially increased the risk of bleeding inside the skull.

No major difference was found between different types of antidepressants and age did not appear to be a factor. However, males appeared to be more at risk than women.

"The addition of NSAIDs to antidepressant treatment increased the risk of intracranial haemorrhage within 30 days of the combination starting, especially in men. This result adds to evidence confirming the increase of risk with combination use of antidepressants and NSAIDs," the researchers said.

Details of these findings are published in the British Medical Journal. In an accompanying editorial, researchers at the Universities of Cambridge and Glasgow in the UK, expressed concern about the findings.

They noted that both antidepressants and NSAIDs are commonly used and the potential for them to be used together is also high as, for example, 65% of people with major depression also suffer with chronic pain.

They called on doctors to be particularly vigilant when prescribing these drugs and to always discuss the risks with patients, especially those in deprived areas where ‘the combination of mental and physical problems, including chronic pain, is very common'.

For more information on depression, see our Depression Clinic here