Do SSRIs cause gastrointestinal bleeding?

Selective serotonin re-uptake inhibitor antidepressants (SSRIs) can inhibit uptake, and therefore storage, of serotonin by platelets. This is significant because release of serotonin from platelets augments their aggregation; so use of SSRIs could, in theory, predispose patients to bleeding disorders. Case reports have suggested a link between SSRIs and easy bruising, nosebleeds, menorrhagia, petechial, ocular, small bowel, rectal and cerebral haemorrhages, and a prolonged bleeding time. Also, the summaries of product characteristics (SPCs) for all SSRIs include warnings about use in patients with a history of bleeding disorders or concomitant use with drugs known to affect platelet function. Here we review the risk of gastrointestinal bleeding associated with the use of SSRIs.