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Cited by 109Gastrointestinal Bleeding Diagnosis and TreatmentAntiplatelet Therapy and Cardiovascular DiseasesInflammatory mediators and NSAID effects

An Association Between Selective Serotonin Reuptake Inhibitor Use and Serious Upper Gastrointestinal Bleeding

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Dall, Michael, Schaffalitzky de Muckadell, Ove B., Lassen, Annmarie Touborg, Hansen, Jane Møller, Hallas, Jesper·2009·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2009.08.019
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Abstract

Background & aims In vitro studies have shown that selective serotonin reuptake inhibitors (SSRIs) inhibit platelet aggregation. It is controversial whether use of SSRIs is a cause of clinically important bleeding; results from observational studies have been equivocal.Methods A population-based case-control study was conducted in Denmark. The 3652 cases all had a first discharge diagnosis of serious upper gastrointestinal bleeding (UGB) from 1995 to 2006. Controls (n = 36,502), matched for age and sex, were selected by risk-set sampling. Data on drug exposure and medical history were retrieved from a prescription database and the county's patient register. Confounders were controlled for by conditional logistic regression and the case-crossover design.Results The adjusted odds ratio (OR) of UGB among current, recent, and past users of SSRIs was 1.67 (95% confidence interval [CI], 1.46-1.92), 1.88 (95% CI, 1.42-2.5), and 1.22 (95% CI, 1.07-1.39). The adjusted OR for concurrent use of SSRI and nonsteroidal anti-inflammatory drugs (NSAIDs) was 8.0 (95% CI, 4.8-13). The adjusted OR for the concurrent use of NSAID, aspirin, and SSRI was 28 (95% CI, 7.6-103). Of the UGB cases, 377 were current users of SSRI; the adjusted OR for UGB in the case crossover analysis was 2.8 (95% CI, 2.2-3.6). The adjusted OR among users of proton pump inhibitors was 0.96 (95% CI, 0.50-1.82).Conclusions Use of SSRI was associated with UGB, consistent with its antiplatelet effects. SSRIs should be prescribed with caution for patients at high risk for UGB.

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Research works printed but not linked: 2

  1. Gaist D, Sørensen HT, Hallas J. The Danish Prescription Regis- tries. Dan Med Bull 1997;44:445-448.
  2. Bjerre LM, LeLorier J. Expressing the magnitude of adverse ef- fects in case-control studies. BMJ 2000;320:503-506.

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Authors
Dall, M., Schaffalitzky de Muckadell, O. B., Lassen, A. T., Hansen, J. M., & Hallas, J.
Affiliations
  • University of Southern Denmark (DK)
  • Odense University Hospital (DK)
Corresponding author
Dall, Michael
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2009-12
Volume
7
Issue
12
Pages
1314-1321
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2009.08.019
OpenAlex
W2111935731
Cited by
109
References
41
Citations by year
2026: 3 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 5 · 2021: 7 · 2020: 3 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 7 · 2015: 7 · 2014: 15 · 2013: 5 · 2012: 9
FWCI
10.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
Syddansk Universitet
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
Keywords
selective serotonin reuptake inhibitors, upper gastrointestinal bleeding, antiplatelet activity, platelet aggregation inhibition, aspirin, proton pump inhibitors, drug-induced bleeding, adverse drug reactions
MeSH terms
Adult, Aged, Aged, 80 and over, Denmark, Female, Gastrointestinal Hemorrhage, Humans, Male, Middle Aged, Case-Control Studies, Selective Serotonin Reuptake Inhibitors

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