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Case 16 - “I Don’t Care”

SSRIs/SNRIs and Bleeding Risk

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Antidepressants, when used appropriately and in combination with an individualized psychosocial approach, can dramatically improve depressive symptoms and the quality of life of residents who have major depressive disorder. The selection of antidepressants needs to take into account the patient’s medical problems, as well as what side effects one wants or wants to avoid for a particular patient. There is no compelling evidence that one antidepressant works better than any other for the treatment of majpr depressive disorder in long-term care populations. Selective serotonin reuptake inhibitors (SSRIs) are probably the most commonly selected first-line medications for the treatment of major depressive disorders in long-term care residents. Serotonin-norepinephrine reuptake inhibitors) have also been associated with a potentially increased risk of bleeding, although the risk appears to be lower compared to SSRIs.

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Chapter
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Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 78 - 82
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

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Further Reading

Andrade, C., & Sharma, E. (2016). Serotonin reuptake inhibitors and risk of abnormal bleeding. Psychiatric Clinics of North America, 39 (3), 413426. doi: 10.1016/j.psc.2016.04.010. Epub 2016 Jun 28. PMID: 27514297.CrossRefGoogle ScholarPubMed
Auerbach, A. D., Vittinghoff, E., Maselli, J., Pekow, P. S., Young, J. Q., & Lindenauer, P. K. (2013). Perioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery. JAMA Internal Medicine, 173 (12), 10751081. doi: 10.1001/jamainternmed.2013.714. PMID: 23699725; PMCID: PMC3867199.CrossRefGoogle ScholarPubMed
Jensen, M. P., Ziff, O. J., Banerjee, G., Ambler, G., & Werring, D. J. (2019). The impact of selective serotonin reuptake inhibitors on the risk of intracranial hemorrhage: A systematic review and meta-analysis. European Stroke Journal, 4 (2), 144152.CrossRefGoogle ScholarPubMed
Laporte, S., Chapelle, C., Caillet, P., Beyens, M. N., Bellet, F., Delavenne, X., & Bertoletti, L. (2017). Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta-analysis of observational studies. Pharmacological Research, 118, 1932.CrossRefGoogle ScholarPubMed
Lee, T., Park, Y., Kim, S., You, H., Kang, J., & Jung, Y. (2020). Concomitant use of NSAIDs or SSRIs with NOACs requires monitoring for bleeding. Yonsei Medical Journal, 61 (9), 741749. https://doi.org/10.3349/ymj.2020.61.9.741CrossRefGoogle ScholarPubMed
McIntyre, R. S., Carvalho, I. P., Lui, L. M., Majeed, A., Masand, P. S., Gill, H., & Rosenblat, J. D. (2020). The effect of intravenous, intranasal, and oral ketamine in mood disorders: A meta-analysis. Journal of Affective Disorders, 276, 576584.CrossRefGoogle ScholarPubMed
Quinn, G. R., Hellkamp, A. S., Hankey, G. J., Becker, R. C., Berkowitz, S. D., Breithardt, G., & Singer, D. E. (2018). Selective serotonin reuptake inhibitors and bleeding risk in anticoagulated patients with atrial fibrillation: An analysis from the ROCKET AF trial. Journal of the American Heart Association, 7 (15), e008755.CrossRefGoogle ScholarPubMed

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  • “I Don’t Care”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.017
Available formats
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Save book to Dropbox

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  • “I Don’t Care”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.017
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “I Don’t Care”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.017
Available formats
×