Selective serotonin reuptake inhibitors (SSRIs), drugs commonly used to treat depression, may double the risk of gastrointestinal bleeding, say researchers from Wake Forest University School of Medicine. And when the drugs are taken with pain medications, the risk is more than 600 percent higher.
"Clinicians who prescribe these medications should be aware of the potential risk and may need to consider alternatives," said researcher Sonal Singh. "In addition, regulatory authorities should consider revising existing package inserts to highlight the magnitude of the risk."
Published in Alimentary Pharmacology & Therapeutics, the study found evidence that SSRIs (such as Paxil, Prozac and Zoloft) may be associated with bleeding of the lining of the digestive tract including the esophagus, stomach or upper part of the small intestine. Upper gastrointestinal bleeding may be potentially serious and require hospitalization for blood transfusions and other treatments.
The researchers also looked at the effects of taking SSRIs at the same time as non-steroidal anti-inflammatory drugs (NSAIDs) such as Celebrex and over-the-counter drugs such as aspirin and Aleve. They found that when the patients also took NSAIDs, the risk of upper gastrointestinal bleeding was six-times higher than in patients taking neither medication. The researchers said the combined use of NSAIDs and SSRIs may have a synergistic effect, which results in the elevated risk of bleeding.
"These findings emphasize the importance of clinicians taking a detailed gastrointestinal history from patients and targeting the use of SSRIs to patients who are at relatively low risk for upper GI bleeding," concluded Singh.
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