Selective serotonin reuptake inhibitors and gastrointestinal bleeding: a case-control study

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Research

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed globally.
• Previous studies suggested a potential association between SSRI use and upper gastrointestinal (GI) bleeding.
• The clinical significance of this potential risk warrants further investigation due to the extensive use of SSRIs.

Purpose of the Study:

• To investigate the association between Selective Serotonin Reuptuptake Inhibitor (SSRI) use and the incidence of upper gastrointestinal (GI) bleeding.
• To quantify the risk of upper GI bleeding in patients using SSRIs compared to non-users.
• To provide robust data on the safety profile of SSRIs concerning upper GI bleeding.

Main Methods:

• A case-control study was conducted in Spanish and Italian hospitals.
• Cases comprised patients aged 18 years or older with endoscopically diagnosed acute upper GI bleeding.
• Controls were matched by sex, age, and admission date, admitted for elective surgery for non-painful disorders; SSRI exposure was defined as use within 7 days prior to the index date.

Main Results:

• The study included 581 cases and 1358 controls, with no significant differences in age or sex distribution after matching.
• SSRI antidepressant use in the week preceding the index date was reported by 4.0% of cases and 3.3% of controls.
• No statistically significant increased risk of upper GI bleeding was observed for SSRI antidepressants (adjusted odds ratio, 1.06; 95% CI, 0.57-1.96).

Conclusions:

• This case-control study found no significant association between the use of Selective Serotonin Reuptake Inhibitors (SSRIs) and an increased risk of upper GI bleeding.
• The findings provide strong evidence that any potential increase in upper GI bleeding risk associated with SSRIs is minimal, not exceeding a magnitude of 2.
• The results suggest that SSRIs can be considered relatively safe concerning upper GI bleeding risk in clinical practice.