Key result
Co-administration of antidepressants with anticoagulants or platelet inhibitors was not significantly associated with increased bleeding severity in patients over 50 years of age.
Why the study?
The effect of co-administering antidepressants and anticoagulants or antiplatelets on increased bleeding risk in the elderly is controversial.
Does the co-administration of antidepressants and anticoagulants/antiplatelets increase bleeding severity in patients over 50 years of age?
Cohort (n=135)
No
Does the co-administration of antidepressants and anticoagulants/antiplatelets increase bleeding severity in patients over 50 years of age?
Answers are grounded in this paper and cite their sources.
In this small retrospective cohort, the co-administration of antidepressants with anticoagulants or antiplatelets was not significantly associated with increased bleeding severity in older adults.
BACKGROUND AND OBJECTIVE: Depression is prevalent in the elderly, to whom the administration of anticoagulants (AC) and antiplatelets (antiaggregants (AG)) is frequent. Antidepressants (AD) work on increasing serotonin levels in the central nervous system (CNS) and are thought to decrease serotonin levels in platelets, an important factor in homeostasis. The effect of the co-administration of AD and AC/AG on increased bleeding risk is controversial; hence, our objective is to determine the effect of AD and AC/AG co-administration on the exacerbation and severity of bleeding in the elderly. SUBJECTS AND METHODS: A monocentric retrospective study was conducted at the Lebanese Hospital Geitaoui by reviewing charts of 135 patients with gastrointestinal bleeding (GIB) and intracranial bleeding (ICB) hospitalized between 2015 and 2020. Proportions of patients treated with AD and AG, AD and AC, AD alone, or untreated with AD were determined. The studied parameters were demographic variants, medical and surgical histories, medication profiles, hemostasis tests, computed tomography (CT) scans, magnetic resonance imaging (MRI), endoscopies, and characteristics of the bleeding classified according to the Bleeding Severity Measurement Score (BSMS). RESULTS: No positive correlation was found between AD and AC/AG co-administration and bleeding. Factors such as gender, age, body mass index (BMI), alcoholism, smoking, hypertension, diabetes, history of malignancy, dyslipidemia, chronic kidney disease (CKD), and coronary artery disease (CAD) were not statistically associated with intracranial hemorrhage (ICH) or GIB. Prothrombin time (PT) and international normalized ratio (INR) were significantly (p < 0.05) associated with bleeding severity. Multivariate analysis showed that bleeding severity increases with the clinical diagnosis (p < 0.001) and in patients with heart failure (p = 0.023). CONCLUSION: Our study could not prove the potential drug-drug interaction (DDI) between AC/AG and AD. With the increased prevalence of mental disorders and prescribed antidepressants, proving the potential drug-drug interaction is of major importance. More research with diverse approaches on a larger scale is required in this regard.
No takes yet. Share an insight, caveat, or question.
Richa et al. (2025) conducted a cohort in Intracranial and gastrointestinal bleeding (n=135). Co-administration of antidepressants and anticoagulants or platelet inhibitors vs. Patients treated with only anticoagulants, platelet inhibitors, or other treatments was evaluated on Bleeding severity (Bleeding Severity Measurement Score) (p=>0.05). Co-administration of antidepressants with anticoagulants or platelet inhibitors was not significantly associated with increased bleeding severity in patients over 50 years of age.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: