ArticleBMJ (Clinical research ed.)2001
Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study.
Article in BMJ (Clinical research ed.), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 3 syntheses or guidelines pooled it, 269 citations in OpenAlex.
- Risk of gastrointestinal bleeding by specific SSRIs and SNRIs: A systematic review and meta-analysis.British journal of clinical pharmacology · 2026Pooled it
- Bleeding events attributable to concurrent use of warfarin and other medications in high-risk elderly: meta-analysis and Italian population-based investigation.European journal of clinical pharmacology · 2018Pooled it
- Antidepressants for agitation and psychosis in dementia.The Cochrane database of systematic reviews · 2011Pooled it
- Association between concomitant use of direct oral anticoagulants with antidepressants and an increased risk of hemorrhage: analysis of the food and drug administration adverse event reporting system database.Frontiers in medicine · 2026Article
- All-Cause Mortality and Bleeding Risks Associated With Serotonin Reuptake Inhibitors in Patients With End-Stage Kidney Disease and Depression: A Nationwide Cohort Study.Psychiatry investigation · 2025Article
- Concomitant Use of Selective Serotonin Reuptake Inhibitors With Oral Anticoagulants and Risk of Major Bleeding.JAMA network open · 2024Article
- Strategies for Avoiding Typical Drug-Drug Interactions and Drug-Related Problems in Patients with Vascular Diseases.Medicina (Kaunas, Lithuania) · 2023Article
- Recent hospitalization and risk of antidepressant initiation in people with Parkinson's disease.BMC geriatrics · 2022Article
- [Gastrointestinal Disease in the Population Aged 80 Years and above in Korea during Recent Decades: Multi-center Cross-sectional Study].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2022Article
- Management of Systemic Medical Emergencies Associated with Psychotropic Medications.Indian journal of psychiatry · 2022Article
- Risk of Bleeding Associated With Antidepressants: Impact of Causality Assessment and Competition Bias on Signal Detection.Frontiers in psychiatry · 2021Article
- Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy.Deutsches Arzteblatt international · 2019Review
- Two novel, putative mechanisms of action for citalopram-induced platelet inhibition.Scientific reports · 2018Article
- Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study.British journal of clinical pharmacology · 2018Article
- Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review.Chonnam medical journal · 2018Review
- Citalopram inhibits platelet function independently of SERT-mediated 5-HT transport.Scientific reports · 2018Article
- A Pharmacoepidemiology Database System for Monitoring Risk Due to the Use of Medicines by New Zealand Primary Care Patients.Drug safety · 2017Article
- Selective Serotonin Reuptake Inhibitor Use and Perioperative Bleeding and Mortality in Patients Undergoing Coronary Artery Bypass Grafting: A Cohort Study.Drug safety · 2015Article
- Effect of selective serotonin reuptake inhibitors on bleeding risk in patients with atrial fibrillation taking warfarin.The American journal of cardiology · 2014Article
- Observational study of upper gastrointestinal tract bleeding events in patients taking duloxetine and nonsteroidal anti-inflammatory drugs: a case-control analysis.Drug, healthcare and patient safety · 2014Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the association between inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding.
designRetrospective cohort study from population based databases.
settingOntario, Canada.
participants317 824 elderly people observed for more than 130 000 person years. The patients started taking an antidepressant between 1992 and 1998 and were grouped by how much the drug inhibited serotonin reuptake. Patients were observed until they stopped the drug, had an upper gastrointestinal bleed, or died or the study ended.
main outcome measureAdmission to hospital for acute upper gastrointestinal bleeding.
resultsOverall, 974 bleeds were observed, with an overall bleeding rate of 7.3 per 1000 person years. After controlling for age or previous gastrointestinal bleeding, the risk of bleeding significantly increased by 10.7% and 9.8%, respectively, with increasing inhibition of serotonin reuptake. Absolute differences in bleeding between antidepressant groups were greatest for octogenarians (low inhibition of serotonin reuptake, 10.6 bleeds/1000 person years v high inhibition of serotonin reuptake, 14.7 bleeds/1000 person years; number needed to harm 244) and those with previous upper gastrointestinal bleeding (low, 28.6 bleeds/1000 person years v high, 40.3 bleeds/1000 person years; number needed to harm 85).
conclusionsAfter age or previous upper gastrointestinal bleeding were controlled for, antidepressants with high inhibition of serotonin reuptake increased the risk of upper gastrointestinal bleeding. These increases are clinically important for elderly patients and those with previous gastrointestinal bleeding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.