Selective serotonin reuptake inhibitors (SSRIs) are associated with an increased risk of gastrointestinal (GI) bleeding, especially when combined with nonsteroidal anti-inflammatory drugs (NSAIDs), according to the results of a population-based cohort study published in the Jan. 13 issue of the Archives of Internal Medicine.
“Serotonin is thought to play an important role in hemostasis, mainly through an enhancing effect on adenosine diphosphate and thrombin,” write Susanne Oksbjerg Dalton, MD, from the Institute of Cancer Epidemiology at the Danish Cancer Society in Copenhagen, and colleagues.
“The SSRIs in therapeutic doses consistently deplete serotonin after several weeks of treatment.” Using the Pharmaco-Epidemiologic Prescription Database of North Jutland, Denmark, the investigators identified 26,005 users of antidepressants in that county from January 1, 1991, to December 31, 1995. Data from the Hospital Discharge Register allowed comparisons of hospitalizations for upper GI bleeding among users of antidepressant medications and among those who did not receive prescriptions for antidepressants.
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