SSRI and anticoagulant mix linked to major bleed risk

SSRI use increases the risk of major bleeding in patients taking certain oral anticoagulants, claim US researchers.

Both drugs have independ-ently been linked to an increased bleeding risk.

However, the latest study showed that in patients taking oral vitamin K antagonists, the use of SSRIs increased the risk of non-GI bleeding by 70 per cent - equivalent to the risk seen with an NSAID.

The study included 70,201 patients in the Netherlands who were taking oral vitamin K antagonists between 1994 and 2004.

Overall, 1,848 cases of major bleeding were recorded in this group, with 67 per cent of cases being non-GI bleeds.

SSRI use was associated with a 70 per cent increased risk of non-GI bleeding, compared with patients taking vitamin K antagonists alone.

But the combination of medications had no statistically significant effect on the risk of GI-bleeding.

The researchers conclude that patients taking an oral anticoagulant should consider taking an alternative antidepressant to SSRIs.

Arch Intern Med 2008; 168:180-5

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