ArticleBritish journal of clinical pharmacology2003
Combined use of SSRIs and NSAIDs increases the risk of gastrointestinal adverse effects.
Article in British journal of clinical pharmacology, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prescribing cascades in community-dwelling adults: A systematic review.Pharmacology research & perspectives · 2022Pooled it
- The impact of CYP2D6 mediated drug-drug interaction: a systematic review on a combination of metoprolol and paroxetine/fluoxetine.British journal of clinical pharmacology · 2018Pooled it
- Understanding antidepressant change patterns in the UK Biobank.The British journal of psychiatry : the journal of mental science · 2026Article
- Home-Based Transcranial Direct Current Stimulation for Menstrual Pain and Premenstrual Symptoms: A Randomized Controlled Trial.International journal of women's health · 2026Article
- Clinical Implications of Antidepressants and Associated Risk of Bleeding: A Narrative Review.Current pain and headache reports · 2025Review
- Anxiolytic Effects ofFoods (Basel, Switzerland) · 2025Article
- Potentially harmful drug-drug interactions in the therapeutic regimens of persons with spinal cord injury.The journal of spinal cord medicine · 2024Observational
- The Effects of CYP2C19 Genotype on Proxies of SSRI Antidepressant Response in the UK Biobank.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Pharmacogenomics of NSAID-Induced Upper Gastrointestinal Toxicity.Frontiers in pharmacology · 2021Review
- Risk of Bleeding Associated With Antidepressants: Impact of Causality Assessment and Competition Bias on Signal Detection.Frontiers in psychiatry · 2021Article
- Impact of Drug-Gene-Interaction, Drug-Drug-Interaction, and Drug-Drug-Gene-Interaction on (es)Citalopram Therapy: The PharmLines Initiative.Journal of personalized medicine · 2020Article
- Prevalence and Accuracy of Information on CYP2D6, CYP2C19, and CYP2C9 Related Substrate and Inhibitor Co-Prescriptions in the General Population: A Cross-Sectional Descriptive Study as Part of the PharmLines Initiative.Frontiers in pharmacology · 2020Article
- Article
- Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies.Drug, healthcare and patient safety · 2015Review
- Adverse drug reactions and drug-drug interactions with over-the-counter NSAIDs.Therapeutics and clinical risk management · 2015Review
- Is combined use of SSRIs and NSAIDs associated with an increased risk of starting peptic ulcer treatment?British journal of clinical pharmacology · 2014Article
- Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease.World journal of gastroenterology · 2014Review
- 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
- Drug interactions in general dental practice--considerations for the dental practitioner.British dental journal · 2014Article
- The risk of bleeding with duloxetine treatment in patients who use nonsteroidal anti-inflammatory drugs (NSAIDs): analysis of placebo-controlled trials and post-marketing adverse event reports.Drug, healthcare and patient safety · 2013Article
Corrections and comments
- Commented on by
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo investigate the relationship between the use of antidepressants with or without NSAIDs and the risk of gastrointestinal side-effects.
methodsThis was a population-based cohort study. Medication data of 180,000 patients from 16 pharmacies in The Netherlands were studied. The subjects were a group of 15 445 new users of antidepressants with or without NSAIDs. A review of patient profiles for cases of gastrointestinal adverse effects caused by first time use of antidepressants with or without NSAIDs was carried out. The number of first prescriptions for peptic ulcer drugs (Anatomical Therapeutic Chemical classification A02B) in the period from day 2 after starting antidepressants with or without NSAIDs until 10 days after the last dose was the main outcome measure.
resultsIn the reference group of 619 new users of nonselective antidepressants (TCAs), the incidence of first prescriptions for peptic ulcer drugs was 0.051 (95% confidence interval 0.021, 0.105). The use of SSRIs (n = 1181) caused a slightly higher incidence rate ratio (IRR) of 1.2 (0.5, 2.8). The combined use of SSRIs and NSAIDs (n = 86) increased the IRR to 12.4 (3.2, 48.0). In contrast, the combination of nonselective antidepressants and NSAIDs (n = 74) increased the IRR to 2.5 (0.3, 20.3).
conclusionsSSRIs increase the risk of gastrointestinal adverse effects in first time users as compared with nonselective antidepressants. The combined use of SSRIs and NSAIDs strongly increases the risk of gastrointestinal adverse effects and should be avoided. The combination of nonselective antidepressants and NSAIDs does not have this effect.
Indexed as
Identifiers
What OpenQuestion holds
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.