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Common Antidepressants Tied to Higher Bleeding Risk in Warfarin Users: Study
Date:11/8/2012

By E.J. Mundell
HealthDay Reporter

THURSDAY, Nov. 8 (HealthDay News) -- Millions of older Americans take the blood thinner warfarin, and many may also take one of a widely used class of antidepressants called SSRIs.

Now, a new study finds that selective serotonin reuptake inhibitors (SSRIs) -- which include Celexa, Paxil, Prozac and Zoloft -- may raise the risk for major bleeding in patients also taking warfarin.

Still, because depression is such a tough-to-treat illness, experts say the finding is no reason for patients on warfarin to immediately drop their SSRI.

"The most important thing would be to talk to their doctor, and perhaps for patients who are on both of these medicines, doctors should just keep a close eye on them," said study author Gene Quinn, who was a resident physician in internal medicine at the University of California, San Francisco, at the time of the study.

He presented the finding this week at the American Heart Association annual meeting, in Los Angeles.

Warfarin has been prescribed for decades to help prevent stroke. According to Quinn, smaller, less rigorous studies have suggested that SSRI antidepressants might interact with warfarin to boost bleeding risks, but those studies hadn't taken other factors, such as a patient's age or level of illness, into account.

In the new study, Quinn and his colleagues took those factors into account while looking at data from an ongoing study of more than 13,000 people with the irregular heartbeat known as atrial fibrillation. Almost 9,200 of the patients were also taking warfarin, and this subset was the focus of the new study.

According to Quinn, the warfarin users were divided into three groups: "Patients who were taking no antidepressants, patients who were taking SSRIs and patients who were taking [older] tricyclic antidepressants."

Comparing the bleeding risks among the three groups, "we found that there was a
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