Association between SSRIs and upper gastrointestinal bleeding

doi:10.1136/bmj.320.7246.1405

BMJ 2000;320:1405 ( 20 May )

Letters

Association between SSRIs and upper gastrointestinal bleeding

Coprescription of antiulcer drugs with SSRIs is fairly common

SSRIs are no more likely than other drugs to cause such bleeding

Self treatment with non-steroidal drugs may be confounding factor

Authors' reply

Coprescription of antiulcer drugs with SSRIs is fairly common

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

EDITOR $---$ The paper by de Abajo et al raises the possibility of an increased risk of upper gastrointestinal bleeding associatedwith selective serotonin reuptake inhibitors.¹ The authorsexcluded patients with cancer, oesophageal varices, Mallory-Weissdisease, alcoholism, liver disease, and coagulopathies, but itis not clear if they excluded patients who were coprescribed antiulcertreatments. They do mention antecedents of upper gastrointestinaldisorders as potential cofounders that were adjustedfor.

To investigate this issue further we examined a large prescription database provided by the general medical services in theRepublic of Ireland. For November 1998 we determined the oddsratios to estimate the relative risk for the coprescription ofantiulcer drugs (including H₂antagonists, proton pump inhibitors,and prostaglandin analogues but excluding antacids) with selectiveserotonin reuptake inhibitors and other antidepressants (table).We excluded people who were coprescribed aspirin, non-steroidalanti-inflammatory agents, or corticosteroids as this may havebeen cytoprotective coprescribing. . . . [Full text of this article]

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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]

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