Cited by 235Gastrointestinal Bleeding Diagnosis and TreatmentInflammatory mediators and NSAID effectsHelicobacter pylori-related gastroenterology studies

The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.

Risk of Upper Gastrointestinal Bleeding With Selective Serotonin Reuptake Inhibitors With or Without Concurrent NonSteroidal Anti-Inflammatory Use: A Systematic Review and Meta-Analysis

Anglin, Rebecca, Yuan, Yuhong, Moayyedi, Paul, Tse, Frances, Armstrong, David, Leontiadis, Grigorios I·2014·American Journal of Gastroenterology

DOI 10.1038/ajg.2014.82

Open this paper in CoChat — free account

Abstract

Objectives There is emerging concern that selective serotonin reuptake inhibitors (SSRIs) may be associated with an increased risk of upper gastrointestinal (GI) bleeding, and that this risk may be further increased by concurrent use of nonsteroidal anti-inflammatory (NSAID) medications. Previous reviews of a relatively small number of studies have reported a substantial risk of upper GI bleeding with SSRIs; however, more recent studies have produced variable results. The objective of this study was to obtain a more precise estimate of the risk of upper GI bleeding with SSRIs, with or without concurrent NSAID use. Methods MEDLINE, EMBASE, PsycINFO, the Cochrane central register of controlled trials (through April 2013), and US and European conference proceedings were searched. Controlled trials, cohort, case-control, and cross-sectional studies that reported the incidence of upper GI bleeding in adults on SSRIs with or without concurrent NSAID use, compared with placebo or no treatment were included. Data were extracted independently by two authors. Dichotomous data were pooled to obtain odds ratio (OR) of the risk of upper GI bleeding with SSRIs +/- NSAID, with a 95% confidence interval (CI). The main outcome and measure of the study was the risk of upper GI bleeding with SSRIs compared with placebo or no treatment. Results Fifteen case-control studies (including 393,268 participants) and four cohort studies were included in the analysis. There was an increased risk of upper…

Integrity signals

Registry

Crossref · 10.1038/ajg.2014.82

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Untitled work
(2014) · Medical Entomology and Zoology · Cited by 17,633
Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials
Sterne, J. A. C., Sutton, A. J., Ioannidis, J. P. A., Terrin, N., Jones, D. R., Lau, J., Carpenter, J., Rucker, G., Harbord, R. M., Schmid, C. H., et al. (2011) · BMJ · doi:10.1136/bmj.d4002 · Cited by 7,709
Use and misuse of population attributable fractions
Rockhill, B., Newman, B., & Weinberg, C. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.1.15 · Cited by 1,683
Calculating measures of biological interaction
Andersson, T., Alfredsson, L., Källberg, H., Zdravkovic, S., & Ahlbom, A. (2005) · European Journal of Epidemiology · doi:10.1007/s10654-005-7835-x · Cited by 1,498
Antidepressant use and risk of adverse outcomes in older people: population based cohort study
Coupland, C., Dhiman, P., Morriss, R., Arthur, A., Barton, G., & Hippisley-Cox, J. (2011) · BMJ · doi:10.1136/bmj.d4551 · Cited by 833
Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis
Ford, A. C., Talley, N. J., Schoenfeld, P. S., Quigley, E. M. M., & Moayyedi, P. (2009) · Gut · doi:10.1136/gut.2008.163162 · Cited by 582
Self-citation
Acute Upper Gi Bleeding: Did Anything Change?
van Leerdam, M. E., Vreeburg, E. M., Rauws, E. A., Geraedts, A. A. M., Tijssen, J. G. P., Reitsma, J. B., & Tytgat, G. N. J. (2003) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07517.x · Cited by 506
Prevention of NSAID-induced gastroduodenal ulcers
Rostom, A., Dube, C., Wells, G. A., Tugwell, P., Welch, V. A., Jolicoeur, E., McGowan, J., Lanas, Á., Rushton, E., & Shukla, T. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002296 · Cited by 470
Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study
de Abajo, F. J., Rodríguez, L. A. G., & Montero, D. (1999) · BMJ · doi:10.1136/bmj.319.7217.1106 · Cited by 454
Use of Selective Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Tract Bleeding: A Population-Based Cohort Study
Dalton, S. O., Johansen, C., Mellemkjær, L., Sørensen, H. T., Nørgård, B., & Olsen, J. H. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.1.59 · Cited by 389
Serotonin Reuptake Inhibitor Antidepressants and Abnormal Bleeding
Andrade, C., Surya, S., Chethan, K. B., & Nagesh, K. S. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09r05786blu · Cited by 306
Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis
MacGillivray, S., Arroll, B., Hatcher, S., Ogston, S., Reid, I., Sullivan, F., Williams, B., & Crombie, I. (2003) · BMJ · doi:10.1136/bmj.326.7397.1014 · Cited by 265
Influence of antidepressants on hemostasis
Halperin, D., & Reber, G. (2007) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2007.9.1/dhalperin · Cited by 241
Trends in psychotropic medication use among U.S. adults
Paulose‐Ram, R., Safran, M. A., Jonas, B. S., Gu, Q., & Orwig, D. (2007) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1367 · Cited by 215
Lower gastrointestinal bleeding
Hreinsson, J. P., Gumundsson, S., Kalaitzakis, E., & Bjornsson, E. S. (2012) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0b013e32835948e3 · Cited by 212
Risk of Upper Gastrointestinal Tract Bleeding Associated With Selective Serotonin Reuptake Inhibitors and Venlafaxine Therapy
de Abajo, F. J., & García‐Rodríguez, L. A. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.7.795 · Cited by 204
Meta‐analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non‐steroidal anti‐inflammatory drugs
Loke, Y. K., Trivedi, A. N., & Singh, S. (2007) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2007.03541.x · Cited by 193
Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications
Lewis, J. D., Bilker, W. B., Brensinger, C. M., Farrar, J. T., & Strom, B. L. (2002) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(02)04395-2 · Cited by 191
Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting
Hreinsson, J. P., Kalaitzakis, E., Guðmundsson, S., & Bjornsson, E. S. (2013) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365521.2012.763174 · Cited by 183
Effects of serotonin on platelet activation in whole blood
Li, N., n, N. H. W., Ladjevardi, M., & Hjemdahl, P. (1997) · Blood Coagulation & Fibrinolysis · doi:10.1097/00001721-199711000-00006 · Cited by 178
Selective Serotonin Reuptake Inhibitors and Increased Bleeding Risk: Are We Missing Something?
Serebruany, V. L. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.03.044 · Cited by 161
Canadian consensus guidelines on long‐term nonsteroidal anti‐inflammatory drug therapy and the need for gastroprotection: benefits versus risks
Rostom, A., Moayyedi, P., & Hunt, R. H. (2008) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2008.03905.x · Cited by 157
Self-citation
Increased Use of Antidepressants in Canada: 1981–2000
Hemels, M. E. H., Koren, G., & Einarson, T. R. (2002) · Annals of Pharmacotherapy · doi:10.1345/aph.1a331 · Cited by 128
Selective Serotonin Reuptake Inhibitors Are Associated With a Modest Increase in the Risk of Upper Gastrointestinal Bleeding
Targownik, L. E., Bolton, J. M., Metge, C. J., Leung, S., & Sareen, J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.128 · Cited by 116
Incidence and determinants of long-term use of antidepressants
Meijer, W. E. E., Heerdink, E. R., Leufkens, H. G. M., Herings, R. M. C., Egberts, T. C. G., & Nolen, W. A. (2004) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-004-0726-3 · Cited by 112
An Association Between Selective Serotonin Reuptake Inhibitor Use and Serious Upper Gastrointestinal Bleeding
Dall, M., Schaffalitzky de Muckadell, O. B., Lassen, A. T., Hansen, J. M., & Hallas, J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.08.019 · Cited by 109
Acid Suppressants Reduce Risk of Gastrointestinal Bleeding in Patients on Antithrombotic or Anti-Inflammatory Therapy
Lin, K. J., Hernández–Dı́az, S., & Rodríguez, L. A. G. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.03.049 · Cited by 105
Increased use of selective serotonin reuptake inhibitors in patients admitted with gastrointestinal haemorrhage: a multicentre retrospective analysis
WESSINGER, S., KAPLAN, M., CHOI, L., WILLIAMS, M., LAU, C., SHARP, L., CROWELL, M. D., KESHAVARZIAN, A., & JONES, M. P. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.02859.x · Cited by 96
Gastro‐intestinal haemorrhage risks of selective serotonin receptor antagonist therapy: a new look
Opatrny, L., Delaney, J. A. ‘., & Suissa, S. (2008) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2008.03154.x · Cited by 95
Does concurrent prescription of selective serotonin reuptake inhibitors and non‐steroidal anti‐inflammatory drugs substantially increase the risk of upper gastrointestinal bleeding?
Tata, L. J., Fortun, P., Hubbard, R., Smeeth, L. L., Hawkey, C. J., Smith, C., Whitaker, H., Farrington, P., Card, T. R., & West, J. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02543.x · Cited by 87
Evidence of prescription of antidepressants for non-psychiatric conditions in primary care: an analysis of guidelines and systematic reviews
Mercier, A., Aubin-Auger, I., Lebeau, J., Schuers, M., Boulet, P., Hermil, J.-L., Royen, P. V., & Peremans, L. (2013) · BMC Family Practice · doi:10.1186/1471-2296-14-55 · Cited by 83
Upper gastrointestinal bleeding associated with NSAIDs, other drugs and interactions: a nested case–control study in a new general practice database
de Abajo, F. J., Gil, M., Bryant, V., Timoner, J., Oliva, B., & García‐Rodríguez, L. A. (2012) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-012-1386-3 · Cited by 75
Moderate and high affinity serotonin reuptake inhibitors increase the risk of upper gastrointestinal toxicity
Lewis, J. D., Strom, B. L., Localio, A. R., Metz, D. C., Farrar, J. T., Weinrieb, R. M., Nessel, L. A., Brensinger, C. M., & Kimmel, S. E. (2008) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1546 · Cited by 68
Use of Serotonergic Drugs and the Risk of Bleeding
Verdel, B. M., Souverein, P. C., Meenks, S. D., Heerdink, E. R., Leufkens, H. G. M., & Egberts, T. C. G. (2010) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2010.240 · Cited by 57
COX‐2‐selective inhibitors and the risk of upper gastrointestinal bleeding in high‐risk patients with previous gastrointestinal diseases: a population‐based case–control study
Nørgård, B. M., Pedersen, L. H., Johnsen, S. P., Tarone, R. E., McLaughlin, J. K., Friis, S., & Sørensen, H. T. (2004) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2004.01913.x · Cited by 56
Risk of Upper Gastrointestinal Bleeding and the Degree of Serotonin Reuptake Inhibition by Antidepressants
Vidal, X., Ibáñez, L., Vendrell, L., Conforti, A., & Laporte, J. (2008) · Drug Safety · doi:10.2165/00002018-200831020-00005 · Cited by 55
Selective Serotonin Reuptake Inhibitors and Gastrointestinal Bleeding: A Case-Control Study
Carvajal, A., Ortega, S., del Olmo, L., Vidal, X., Aguirre, C., Ruiz, B., Conforti, A., Leone, R., López-Vázquez, P., Figueiras, A., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019819 · Cited by 48
Fluoxetine and sertraline stimulate gastric acid secretion via a vagal pathway in anaesthetised rats
Abdel‐Salam, O. M. E. (2004) · Pharmacological Research · doi:10.1016/j.phrs.2004.01.010 · Cited by 37
Antidepressant Drug Prescription and Risk of Abnormal Bleeding
Barbui, C., Andretta, M., Vitis, G. D., Rossi, E., D'Arienzo, F., Mezzalira, L., Rosa, M. D., Cipriani, A., Berti, A., Nosè, M., et al. (2009) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181929f7a · Cited by 30
Risk factors for gastrointestinal bleeding: a hospital-based case-control study
Vonbach, P., Reich, R., Moll, F. L., & Meier, C. R. (2007) · Swiss Medical Weekly · doi:10.4414/smw.2007.11912 · Cited by 23
Risikofaktorer for blødende magesår
Søberg, T., Hofstad, B., Sandvik, L., Johansen, M., & Lygren, I. (2010) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.08.0693 · Cited by 10
Risk factors for peptic ulcer bleeding
Zhou, H., & Lv, N. (2010) · World Chinese Journal of Digestology · doi:10.11569/wcjd.v18.i33.3544 · Cited by 6
Selective Serotonin Reuptake Inhibitors and Risk of Gastrointestinal Bleeding in Two Prospective, Population-Based Cohorts
Huang, E. S., Khalili, H., Strate, L. L., & Chan, A. T. (2011) · Gastroenterology · doi:10.1016/s0016-5085(11)60557-x · Cited by 4

Sorted by citations

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,181
Management of severe perioperative bleeding
Kozek‐Langenecker, S. A., Afshari, A., Albaladejo, P., Aldecoa, C., ROBERTIS, E. D., Filipescu, D. C., Fries, D. R., Görlinger, K., Haas, T., Imberger, G. L., et al. (2013) · European Journal of Anaesthesiology · doi:10.1097/eja.0b013e32835f4d5b · Cited by 911
Management of severe perioperative bleeding
Kozek‐Langenecker, S. A., Ahmed, A. B., Afshari, A., Albaladejo, P., Aldecoa, C., Barauskas, G., ROBERTIS, E. D., Faraoni, D., Filipescu, D. C., Fries, D. R., et al. (2017) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000000630 · Cited by 817
Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines
Cleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759
“A recent meta-analysis looked at upper gastrointestinal (GI) bleeding with SSRI use, and found 15 case-control studies (393,268 participants) and four cohort studies (Anglin et al., 2014).”
Background
The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature
Carvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447034 · Cited by 650

See all 235

Authors: Anglin, R., Yuan, Y., Moayyedi, P., Tse, F., Armstrong, D., & Leontiadis, G. I.
Affiliations: McMaster University (CA)
Corresponding author: Anglin, Rebecca
ORCID: Anglin, Rebecca
Yuan, Yuhong
Moayyedi, Paul
Tse, Frances
Armstrong, David
Leontiadis, Grigorios I
Venue: American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-06
Volume: 109
Issue: 6
Pages: 811-819
ISSN: 0002-9270 (ISSN-L)
DOI: 10.1038/ajg.2014.82
OpenAlex: W1970727094
Cited by: 234
References: 44
Citations by year: 2026: 18 · 2025: 17 · 2024: 14 · 2023: 12 · 2022: 21 · 2021: 16 · 2020: 14 · 2019: 22 · 2018: 24 · 2017: 35 · 2016: 19 · 2015: 17 · 2014: 4
FWCI: 4.10
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (unspecified)
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
Health Sciences › Medicine › Pharmacology (medical) › Inflammatory mediators and NSAID effects
Health Sciences › Medicine › Gastroenterology › Helicobacter pylori-related gastroenterology studies
Keywords: upper gastrointestinal bleeding, selective serotonin reuptake inhibitors, nonsteroidal anti-inflammatory drugs, drug-drug interactions, adverse drug reactions, antidepressant safety, number needed to harm, risk estimation, combination therapy, prescribing precautions, depression treatment, antidepressant side effects, NSAID adverse effects, antidepressant discontinuation
MeSH terms: Anti-Inflammatory Agents, Non-Steroidal, Drug Therapy, Combination, Gastrointestinal Hemorrhage, Humans, Risk Factors, Incidence, Selective Serotonin Reuptake Inhibitors, Risk Assessment, Upper Gastrointestinal Tract

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Risk of Upper Gastrointestinal Bleeding With Selective Serotonin Reuptake Inhibitors With or Without Concurrent NonSteroidal Anti-Inflammatory Use: A Systematic Review and Meta-Analysis

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks