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Popular Antidepressants Linked to GI Bleeding
Date:7/7/2008

em with 10,000 "control" patients with no GI bleeding.

More people who had GI bleeding (5.3 percent) were taking SSRIs, compared to 3 percent of the controls -- an increased risk of 60 percent. Similarly, 1.1 percent of patients with GI bleeding were taking Effexor (venlafaxine, an antidepressant related to SSRIs), compared with 0.3 percent in the control group, an almost threefold increased risk.

And there was an almost fivefold increased risk of GI bleeding among users of SSRIs and NSAIDs or corticosteroids, and a ninefold increased risk among those taking NSAIDs and SSRIs without acid-suppressing agents, according to the study.

Both NSAIDs, a class of pain relievers that includes ibuprofen and naproxen, and corticosteroids have known negative effects on the GI tract.

There was also a "suggestion" of an interaction of SSRIs with antiplatelet drugs, which prevent blood clots from forming.

The study authors did not find a significant association for other types of antidepressants.

Based on these numbers, for every 2,000 people treated with one of these antidepressants, there would be one case of upper GI tract bleeding, higher than in the general population. But when NSAID drugs are added, there would be one case of GI bleeding among every 250 people taking the antidepressants, the study authors said.

"There has been a bit of controversy about the significance of this. This is the best study to date to look at this," said Dr. Joseph White, associate professor of internal medicine at Texas A&M Health Science Center College of Medicine and chief of laboratory medicine at Scott & White Clinic. "The risk probably does appear real, but it's slight, unless you're taking concomitant medications. If you're taking these antidepressants along with other medications, keep it in mind and discuss with your physician."

The study's lead author, Dr. Francisco J. de Abajo, said: "The inc
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