Increased use of selective serotonin reuptake inhibitors in patients admitted with gastrointestinal haemorrhage: a multicentre retrospective analysis
Open accessAbstract
Summary: Background Selective serotonin reuptake inhibitors (SSRIs) can adversely affect platelet function and impair haemostasis. Various bleeding complications have been reported in persons taking SSRIs including an increased risk of gastrointestinal haemorrhage (GIH). Aim To evaluate SSRI use in patients hospitalized with GIH compared with controls. Methods A retrospective, multicentre case–control study determined use of SSRIs, non‐steroidal anti‐inflammatory drugs (NSAIDs), aspirin, clopidogrel, coumadin and enoxaparin in patients admitted with GIH and age‐ and sex‐matched controls. Exclusion criteria included liver disease, portal hypertension or bleeding diathesis. Results A total of 579 cases were matched with 1000 controls. SSRI use was 19.2% in cases and 13.6% in controls [OR (95% CI) = 1.5 (1.2–2.0); P = 0.003]. NSAIDs were used by 7.3% of cases and 3.8% of controls [OR = 2.0 (1.3–3.1); P = 0.003]. SSRI use was more strongly associated with lower [1.8 (1.2–2.8)] rather than upper [1.3 (0.83–1.9)] GIH. Significant interactions existed for SSRI use with NSAIDs and aspirin. Conclusions Patients admitted with GIH gastrointestinal bleeding were more likely to be taking SSRIs than controls. This association exists for lower as well as upper GIH. Physicians should be aware of this risk particularly in patients already using medications that increase GIH risk.
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Three studies showed that the bleeding risk increased with low-dose aspirin or NSAID.
“Three studies further showed that the bleeding risk increased with low-dose aspirin or NSAID.192021”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [21]
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- Authors
- WESSINGER, S., KAPLAN, M., CHOI, L., WILLIAMS, M., LAU, C., SHARP, L., CROWELL, M. D., KESHAVARZIAN, A., & JONES, M. P.
- Affiliations
- Northwestern University (US)
- Mayo Clinic (US)
- Rush University (US)
- Mayo Clinic in Arizona (US)
- Corresponding author
- JONES, M. P.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2006-03-17
- Volume
- 23
- Issue
- 7
- Pages
- 937-944
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2045505967
- Cited by
- 96
- References
- 20
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 7 · 2013: 8 · 2012: 7
- FWCI
- 10.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- 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 › Surgery › Helicobacter pylori-related gastroenterology studies
- Keywords
- gastrointestinal bleeding, bleeding risk, nonsteroidal anti-inflammatory drugs, aspirin, clopidogrel, anticoagulants, platelet function, drug interactions, lower gastrointestinal bleeding, upper gastrointestinal bleeding
- MeSH terms
- Clopidogrel, Aged, Anti-Inflammatory Agents, Non-Steroidal, Anticoagulants, Aspirin, Black or African American, Blood Coagulation, Drug Interactions, Female, Gastrointestinal Hemorrhage, Hispanic or Latino, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors, Retrospective Studies, Risk Factors, Ticlopidine, Warfarin, Case-Control Studies, Selective Serotonin Reuptake Inhibitors, Enoxaparin, White People
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