Newer Antidepressants May Increase Bleeding Risk

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Newer Antidepressants May Increase Bleeding Risk Health - ReutersNewer Antidepressants May Increase Bleeding RiskMon By Merritt McKinney NEW YORK (Reuters Health) - A widely prescribed class of antidepressant drugs may increase the risk of bleeding in the gastrointestinal tract, according to a new study from Denmark. But one of the study's authors stressed that bleeding was still rare in people taking antidepressants known as SSRIs, or selective serotonin reuptake inhibitors. SSRIs include Paxil (paroxetine), Prozac (fluoxetine) and Zoloft (sertraline). "Our study showed that SSRIs are probably a risk factor for upper gastrointestinal bleeding," Dr. Henrik Toft Sorensen told Reuters Health. However, the study is not the final word on the subject, according to Sorensen, who is at the University of Aarhus in Denmark. One of the limitations of the study, Sorensen said, was that researchers were not able to take into account smoking and drinking, both of which can increase the risk of gastrointestinal bleeding. Since gastrointestinal bleeding was still rare in people taking SSRIs, "the risk should be balanced against any therapeutic effect for the depression," Sorensen said. The study included about 26,000 residents of a Danish county who had been prescribed an antidepressant--SSRI or other types--during the first half of the 1990s. Among people who were taking an SSRI, but not any other medications that could increase the risk of bleeding, episodes of upper gastrointestinal bleeding were more than three times more common than in similar people who were not taking the drugs. This risk jumped even higher in people who were taking an SSRI in combination with a nonsteroidal anti-inflammatory drug or low-dose aspirin, both of which can increase bleeding risk on their own. All types of SSRIs seemed to increase the risk of bleeding the same amount. Antidepressants that were not SSRIs but that still acted on serotonin were also associated with an increased risk of gastrointestinal bleeding, but not as much as SSRIs. In people who were taking non-SSRI antidepressants, however, their risk of bleeding stayed the same even after they stopped taking the drugs, suggesting that some other factors may have influenced their risk. In contrast, the risk of bleeding returned to normal once people stopped taking SSRIs. This suggests that this class of drugs may be to blame for the increased risk of bleeding, according to the researchers. The study, which is published in the January 13th issue of the journal Archives of Internal Medicine (news - web sites), is not the first to suggest that SSRIs may increase the risk of bleeding. To battle depression, SSRIs keep levels of the chemical serotonin high. Serotonin is not important only to the brain, however. Blood components called platelets use serotonin to stop bleeding. Since platelets cannot make serotonin on their own, researchers suspect that SSRIs increase the risk of bleeding by sucking serotonin from the blood to the brain. SOURCE: Archives of Internal Medicine 2003;163:59-64.