BMJ 1999;319:1081-1082 ( 23 October )

Editorials

Antidepressants and upper gastrointestinal bleeding

New results suggest a link

General practice p   1106

The first 150 words of the full text of this article appear below.

Is there an increased risk of upper gastrointestinal bleeding associated with antidepressant therapy? Most clinicians probably think this unlikely. Indeed, despite spontaneous case reports,1-3 most drug reference sources, including the British National Formulary and the Data Sheet Compendium, do not mention any such association. In this issue, however, de Abajo et al report that there is indeed an increased risk with selective serotonin reuptake inhibitors (p 1106).4 Moreover, they suggest a possible interaction with non-steroidal anti-inflammatory agents, leading to an increased risk far beyond a simple additive effect. How robust are these results and what are the implications for clinical practice?

Retrospective observational studies are always subject to confounding, and the present case-control study is no exception. However, this study seems to be less prone to it. Upper gastrointestinal bleeding is not generally known to be associated with serotonin reuptake inhibitors, so channelling bias5 is less likely. The . . . [Full text of this article]
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BMJ 1999 319: 0. [Full Text] [PDF]

Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study
Francisco José de Abajo, Luis Alberto García Rodríguez, and Dolores Montero
BMJ 1999 319: 1106-1109. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

  • van Walraven, C, Mamdani, M M, Wells, P S, Williams, J I (2001). Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study. BMJ 323: 655-655 [Abstract] [Full text]  
  • (2000). SSRIs, NSAIDs, and Upper GI Bleeding. JWatch Women's Health 2000: 2-2 [Full text]  
  • (1999). SSRIs May Increase GI Bleeding Risk. JWatch General 1999: 1-1 [Full text]  
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