Does serotonin reuptake inhibitor use increase bleeding complications in patients on anticoagulant or antiplatelet agents?
The use of serotonin reuptake inhibitors in patients on antithrombotic therapy is associated with an increased risk of bleeding complications, necessitating careful risk-benefit assessment.
CRD42018083917KEY MESSAGESIn this meta-analysis of 32 non-randomized studies, SRI users were associated with the risk of bleeding complications compared to non-SRI users, with concurrent antithrombotic use (either anticoagulant or antiplatelet).The risk was consistently elevated across types of bleeding events (major bleeding, gastrointestinal bleeding, or any bleeding events), whereas only anticoagulant use was associated with intracranial haemorrhage.To promote the rational use of medicines, our findings suggest that the risk-benefit ratio must account for the clear efficacy of SRI against safety concerns in terms of bleeding risks.
Nochaiwong et al. (2021) studied this question.
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