Which NSAID is preferred when using SSRI/SNRI medications?

The preferred NSAID when using SSRIs/SNRIs is sulindac due to its pharmacological profile and safety considerations. SSRIs and SNRIs can increase the risk of gastrointestinal bleeding, a concern that arises with NSAID use. Sulindac is selectively COX-2 inhibiting and tends to have a lower gastrointestinal side effect profile compared to non-selective NSAIDs like naproxen and aspirin.

Naproxen, while effective for pain relief, does not specifically mitigate the gastrointestinal risks associated with concurrent use of SSRIs and SNRIs. Ketorolac is another NSAID that poses a high risk for gastrointestinal side effects and is typically reserved for short-term use due to its potential for serious complications. Aspirin, being a non-selective NSAID, can exacerbate bleeding risks and is not recommended in combination with SSRIs/SNRIs without careful consideration.

Thus, sulindac's unique attributes make it the safer choice among NSAIDs when managing pain in patients who are also treating conditions with SSRIs or SNRIs.