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Review of gastrointestinal bleeding during use of SSRIs combined with use of NSAID

Published online by Cambridge University Press:  01 September 2022

M. Arts*
Affiliation:
GGZWNB, Psychiatry, Halsteren, Netherlands
S. Petrykiv
Affiliation:
GGZWNB, Psychiatry, Halsteren, Netherlands
L. De Jonge
Affiliation:
Leonardo Scientific Research Institute, Neuropsychiatry, Halsteren, Netherlands
*
*Corresponding author.

Abstract

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Introduction

In recent years, more and more attention has been paid to the risks of using SSRIs. This group of antidepressants may be associated with an increased risk of gastrointestinal bleeding. This risk would be even further increased with concomitant use of NSAIDs. A number of studies have described this interaction, however they reported conflicting results.

Objectives

Our objective was to investigate the risk of gastrointestinal bleeding with SSRIs, with or without NSAID use.

Methods

We performed a literature search, using Pubmed, EMBASE, and Cochrane library, in order to investigate controlled trials, cohort, case-control and cross-sectional studies that reported the incidence of gastrointestinal bleeding s on SSRIs with or without concurrent NSAID use, compared to placebo or no treatment.

Results

15 case-control studies and 4 cohort studies were included in the analysis. There was an increased risk of gastrointestinal bleeding with SSRIs in the cohort studies and case-control studies. The risk of gastrointestinal bleeding was even further increased with the combined use of both SSRIs and NSAIDs.

Conclusions

SSRIs are associated with a modest increase of gastrointestinal bleeding. However, this risk is significantly increased when SSRIs are used in combination with NSAIDs. Psychiatrists should be aware of the hazards in prescribing these medications together.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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