Selective Serotonin Reuptake Inhibitors and Bleeding Risk in the Geriatric Population

The demographics of the United States (US) are evolving as time progresses. The geriatric population is growing, with many elderly people dealing with mental health issues. Major depressive episodes affect 1 to 5 percent of those aged 65 years or older, which emphasizes the importance of addressing mental health concerns in this populace. This article explores how antidepressant use can lead to bleeding problems in geriatric patients, as the prevalence of treatment-resistant depression in these patients is increasing, along with the identification of the potentially life-threatening bleeding risks associated with these medications.

We did a comprehensive literature search using PubMed, EBSCOhost, and Google Scholar to find the articles pertinent to our subject. Reference lists of relevant articles were also reviewed.

These findings highlight the heightened risk of severe bleeding events linked to use of selective serotonin reuptake inhibitors (SSRIs) in the elderly. This was most notable among octogenarians and those with a history of upper gastrointestinal (GI) bleeding. This risk is accentuated when SSRIs are combined with antiplatelet drugs and nonsteroidal anti-inflammatory drugs (NSAIDs), the highest risk being observed with use of a combination of aspirin, clopidogrel, and SSRIs. Our review concludes that while the relative risk is high, the absolute risk remains low. However, caution is advised when prescribing SSRIs to individuals aged 80 years or older. These findings emphasize the need for tailored medication management, vigilant monitoring, and a patient-centered approach in prescribing antidepressants to geriatric patients. Balancing mental healthcare with potential bleeding risks is paramount in the evolving landscape of geriatric mental health.