New study of antidepressants
Publication Date:08/07/2008
Some commonly used antidepressants carry a small risk of causing bleeding inside your stomach, new research says. The risk is bigger when antidepressants are combined with other drugs that irritate your stomach, such as ibuprofen.
What do we know already?
Medicines called selective serotonin reuptake inhibitors (SSRIs) are a common treatment for depression. One of the most well known is fluoxetine (brand name Prozac). SSRIs can be a useful treatment for people with more severe depression, but they can have side effects.
Previous research has suggested that SSRIs might increase the risk of getting bleeding from your stomach lining. It's possible they do this by stopping your blood clotting so easily. Bleeding in the stomach might not have any symptoms, but it can sometimes lead to serious complications.
Now researchers have looked at more than 1,300 people who got bleeding in their stomach and compared them with 10,000 healthy people. The researchers looked at the medicines everyone was taking, to see if particular drugs were linked to a risk of bleeding.
What does the new study say?
People taking SSRIs were slightly more likely to get bleeding in their stomach. There was also an increase in risk with a drug called venlafaxine, which is an antidepressant drug that works in a similar way to SSRIs.
However, the chance of getting bleeding was small. If 2,000 people took an SSRI for a year, one extra person would get bleeding in their stomach.
The risk is bigger if you regularly take other medicines that irritate your stomach, as well as an SSRI. For example, NSAIDs are a common type of painkiller, often used to treat arthritis. Ibuprofen is a well-known NSAID. If 250 people took an SSRI alongside an NSAID for a year, there would be one extra case of bleeding.
The researchers also found that some medicines can help protect the stomach from damage. Drugs to reduce the amount of acid in your stomach can cut the risk of bleeding.
Where does the study come from?
The researchers were based at the Spanish Agency for Medicines and Healthcare Products and the Spanish Centre for Pharmacoepidemiologic Research, both in Madrid. The study appeared in a medical journal called Archives of General Psychiatry, published by the American Medical Association. The study was partly funded by the drug company AstraZeneca.
How reliable are the findings?
The researchers did their study by looking at the health records of thousands of people in the UK. But they only looked at bleeding in the stomach that was serious enough to need hospital or specialist treatment. The study might have missed less serious cases of bleeding.
What does this mean for me?
The risk of bleeding that comes from taking an SSRI on its own is quite small. But it's worth bearing in mind, especially if you're regularly taking other medicines that can irritate your stomach.
SSRIs that are prescribed in the UK include:
- fluoxetine (brand name Prozac)
- fluvoxamine (Faverin)
- paroxetine (Seroxat)
- sertraline (Lustral)
- citalopram (Cipramil).
What should I do now?
If you're taking an SSRI and you're worried about getting bleeding in your stomach, make an appointment to see your doctor. He or she can help you work out your risk of stomach problems. Your doctor may suggest medicines that protect your stomach.
It's important not to stop taking SSRIs suddenly. They can cause unpleasant withdrawal symptoms if you do.
If you get bleeding in your stomach it can make you anaemic. This means you feel weak or tired. It's also possible to vomit blood, or see dark, blackish blood in your stools. It's also possible to get an ulcer on your stomach lining, which can be extremely painful. If you get any of these symptoms, see your doctor as soon as you can.
Although bleeding isn't a common side effect in people taking SSRIs, some other side effects are more common. These include a dry mouth, feeling sick, indigestion, diarrhoea, constipation or loss of appetite.
From:
de Abajo FJ, García Rodríguez. LA. Risk of upper gastrointestinal tract bleeding associated with selective serotonin reuptake inhibitors and venlafaxine therapy. Archives of General Psychiatry. 2008; 65: 795-803.
To read more, see our information on depression.
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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
