What is the clinical evidence from this study?

Study design: Review. Population: Major Depressive Disorder (MDD). Intervention: Selective Serotonin Reuptake Inhibitors (SSRIs). Primary outcome: Bleeding risk.

What question did this study set out to answer?

To review the clinical evidence and biological mechanisms underlying bleeding risks and adverse events associated with selective serotonin reuptake inhibitor (SSRI) therapy.

November 2, 2022Health psychology researchOpen Access

Selective Serotonin Reuptake Inhibitors and Associated Bleeding Risks: A Narrative and Clinical Review

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Key result

SSRIs are associated with increased bleeding risk in some studies, including a 30% to 70% increased risk when combined with vitamin K antagonists in hospitalized patients.

Why the study?

Given the high prevalence of conditions treated with SSRIs and conflicting literature regarding perioperative and hemorrhagic complications, the bleeding risks associated with this medication class merit review.

Do Selective Serotonin Reuptake Inhibitors (SSRIs) increase the risk of bleeding?

Design

Narrative and clinical review

Authors

AEAmber N. EdinoffBoston University KRKeerthiga RaveendranPSG Institute of Medical Sciences & Research MCMarc A. ColonLouisiana State University

Discussion

Member takes

Implication

May warrant caution with SSRI-NSAID or SSRI-VKA combinations; leaves open prospective confirmation.

Key Points

To review the clinical evidence and biological mechanisms underlying bleeding risks and adverse events associated with selective serotonin reuptake inhibitor (SSRI) therapy.
Narrative and clinical review evaluating published literature on SSRI mechanisms, perioperative complications, and bleeding outcomes.
SSRI-induced blockade of the serotonin transporter impairs platelet dense granule storage and aggregation while elevating gastric acid secretion, primarily predisposing patients to upper gastrointestinal and intracranial hemorrhages.
Combining SSRIs with nonsteroidal anti-inflammatory drugs substantially escalates upper gastrointestinal bleeding, while co-prescription with vitamin K antagonists raises bleeding risk between 30% and 70% in hospitalized cohorts.
Evidence regarding perioperative hemorrhage remains mixed across clinical studies, with some indicating heightened surgical bleeding hazards while others find no significant association.

Structured PICO

Do Selective Serotonin Reuptake Inhibitors (SSRIs) increase the risk of bleeding?

Population

Patients treated with Selective Serotonin Reuptake Inhibitors (SSRIs) for conditions such as Major Depressive Disorder

Exposure

Selective Serotonin Reuptake Inhibitors (SSRIs)

Outcome

Bleeding risks (upper gastrointestinal, intracranial, and perioperative)safety

SSRIs are associated with increased bleeding risks, particularly when combined with NSAIDs or vitamin K antagonists, due to their effects on platelet aggregation and gastric acid secretion.

Cite This Study

Edinoff et al. (2022) conducted a review in Major Depressive Disorder (MDD). Selective Serotonin Reuptake Inhibitors (SSRIs) was evaluated on Bleeding risk. SSRIs are associated with increased bleeding risk in some studies, including a 30% to 70% increased risk when combined with vitamin K antagonists in hospitalized patients.

synapsesocial.com/papers/6a881555580ea41f015830b3 https://doi.org/10.52965/001c.39580

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Selective Serotonin Reuptake Inhibitors and Associated Bleeding Risks: A Narrative and Clinical Review

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Selective Serotonin Reuptake Inhibitors and Associated Bleeding Risks: A Narrative and Clinical Review

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider