Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin Gastroenterol Hepatol. 2015 Jan;13(1):42-50.e3. doi: 10.1016/j.cgh.2014.06.021. Epub 2014 Jun 30.

Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis.

Author information

1
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
2
Department of Infectious Diseases, Taizhou Hospital Affiliated to Wenzhou Medical College, Linhai, Zhejiang, China.
3
Department of Traditional Chinese Medicine, The Seventh People's Hospital of Hangzhou, Hangzhou, Zhejiang, China.
4
Department of Hematology, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.
5
Department of Traditional Chinese Medicine, The Seventh People's Hospital of Hangzhou, Hangzhou, Zhejiang, China. Electronic address: hz_yhzhang@hotmail.com.
6
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: hzruanbing@gmail.com.

Abstract

BACKGROUND & AIMS:

Selective serotonin reuptake inhibitors (SSRIs) are used to treat various psychiatric disorders. However, there are concerns that SSRIs increase the risk for upper gastrointestinal bleeding (UGIB).

METHODS:

We performed a systematic review and meta-analysis of controlled observational studies to determine whether SSRI use affects the risk for UGIB. Our analysis included all observational studies that compared UGIB development among patients receiving SSRIs vs no treatment. We calculated pooled odds ratios using random- and fixed-effects models.

RESULTS:

A total of 22 studies (6 cohort and 16 case-control studies) involving more than 1,073,000 individuals were included in our meta-analysis. In comparing SSRI users with patients who had not taken SSRIs, the odds for developing UGIB were 1.55-fold higher (odds ratio, 1.55; 95% confidence interval, 1.35-1.78). In subgroup analyses, the association was greatest for patients who received concurrent therapy with nonsteroidal anti-inflammatory or antiplatelet drugs; we found no significant increase in the risk of developing UGIB among patients receiving concurrent acid-suppressing drugs.

CONCLUSIONS:

SSRI use was associated with an almost 2-fold increase in the risk of developing UGIB, especially among patients at high risk for GI bleeding (concurrent use of nonsteroidal anti-inflammatory or antiplatelet drugs). This risk might be reduced significantly by concomitant use of acid-suppressing drugs.

KEYWORDS:

5HT; Antidepressant; Hemorrhage; Stomach

PMID:
24993365
DOI:
10.1016/j.cgh.2014.06.021
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center