TY - JOUR
T1 - Selective serotonin reuptake inhibitor use and risk of gastrointestinal and intracranial bleeding
AU - Yuet, Wei Cheng
AU - Derasari, Dhvani
AU - Sivoravong, Jon C.
AU - Mason, David
AU - Jann, Michael
N1 - Publisher Copyright:
© 2019 American Osteopathic Association.
PY - 2019/2
Y1 - 2019/2
N2 - Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed medications in the United States. Although SSRIs are highly tolerable relative to other antidepressants, they are associated with a number of adverse effects, including increased gastrointestinal tract bleeding and intracranial bleeding. Mechanisms include increased gastric acid secretion and inhibition of serotonin entrance into platelets. Patients with other bleeding risk factors, such as warfarin, clopidogrel, or aspirin use, may be at heightened risk of these adverse effects. The purpose of this article is to review the incidence of gastrointestinal tract bleeding or intracranial bleeding associated with concomitant SSRI use, the proposed mechanisms of, and the potential pharmacokinetic/pharmacodynamic interactions with anticoagulants and antiplatelets. Given the prevalence of SSRI use in the ambulatory setting, osteopathic physicians should be aware of potential drug-drug interactions and the clinical implications of SSRI-associated bleeding risk.
AB - Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed medications in the United States. Although SSRIs are highly tolerable relative to other antidepressants, they are associated with a number of adverse effects, including increased gastrointestinal tract bleeding and intracranial bleeding. Mechanisms include increased gastric acid secretion and inhibition of serotonin entrance into platelets. Patients with other bleeding risk factors, such as warfarin, clopidogrel, or aspirin use, may be at heightened risk of these adverse effects. The purpose of this article is to review the incidence of gastrointestinal tract bleeding or intracranial bleeding associated with concomitant SSRI use, the proposed mechanisms of, and the potential pharmacokinetic/pharmacodynamic interactions with anticoagulants and antiplatelets. Given the prevalence of SSRI use in the ambulatory setting, osteopathic physicians should be aware of potential drug-drug interactions and the clinical implications of SSRI-associated bleeding risk.
KW - Selective serotonin reuptake inhibitor
KW - Ssri
UR - http://www.scopus.com/inward/record.url?scp=85060661694&partnerID=8YFLogxK
U2 - 10.7556/jaoa.2019.016
DO - 10.7556/jaoa.2019.016
M3 - Review article
C2 - 30688347
AN - SCOPUS:85060661694
SN - 0098-6151
VL - 119
SP - 102
EP - 111
JO - Journal of the American Osteopathic Association
JF - Journal of the American Osteopathic Association
IS - 2
ER -