ReviewCNS drugs2006
SSRIs and upper gastrointestinal bleeding: what is known and how should it influence prescribing?
Review in CNS drugs, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis 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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 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
- Effect of age, weight, and CYP2C19 genotype on escitalopram exposure.Journal of clinical pharmacology · 2010Trial
- Selective serotonin reuptake inhibitors: measurement of effect on platelet function.Translational research : the journal of laboratory and clinical medicine · 2008Trial
- Autism Spectrum Disorder in a Child with Megalencephaly-capillary Malformation-polymicrogyria Syndrome: A Case Report.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2025Article
- Outcomes of Upper Gastrointestinal Bleeding in Hospitalized Patients With Generalized Anxiety Disorder.Cureus · 2022Article
- The impact of selective serotonin reuptake inhibitors on the risk of intracranial haemorrhage: A systematic review and meta-analysis.European stroke journal · 2019Article
- Potential Role of Selective Serotonin Reuptake Inhibitors in Improving Functional Outcome after Stroke.CNS drugs · 2018Review
- Serotonin reuptake inhibitors and post-gastrostomy bleeding: reevaluating the link.Therapeutics and clinical risk management · 2015Article
- Evaluation of risk factors in patients with vitamin K-dependent coagulopathy presumed to be caused by exposure to brodifacoum.The Korean journal of internal medicine · 2014Article
- Identification and weighting of the most critical "real-life" drug-drug interactions with acenocoumarol in a tertiary care hospital.European journal of clinical pharmacology · 2013Article
- The importance of drug-drug interactions as a cause of adverse drug reactions: a pharmacovigilance study of serotoninergic reuptake inhibitors in France.European journal of clinical pharmacology · 2012Article
- Article
- Review
- SSRI-induced coagulopathy: is it reality?Therapeutic advances in psychopharmacology · 2011Article
- Consultation-liaison psychiatry for patients with headaches.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2011Article
- The use of antidepressants and the risk of haemorrhagic stroke: a nested case control study.British journal of clinical pharmacology · 2011Article
- Article
- Identifying and assessing benefit-risk in primary care--a family physician's perspective.Rheumatology (Oxford, England) · 2010Review
- Upper gastrointestinal bleeding in a patient with depression receiving selective serotonin reuptake inhibitor therapy.Indian journal of pharmacology · 2009Article
- Does direct-to-consumer advertising of antidepressants lead to a net social benefit?PharmacoEconomics · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
SSRIs have achieved a high usage rate in the treatment of depression because of a similar efficacy to TCAs and a favourable safety and tolerability profile. However, SSRI use has been associated with bleeding. We reviewed the epidemiological evidence on the association between SSRI use alone and the risk of upper gastrointestinal bleeding, and on synergistic effects reported with other commonly used drugs that can also cause bleeding.A literature search identified four studies of SSRI use and risk for upper gastrointestinal bleeding and a further two studies of SSRI use and bleeding in general, including upper gastrointestinal bleeding. The available evidence indicates quite convincingly that SSRI use may play a causal role in upper gastrointestinal bleeding and that these drugs may act synergistically with other bleeding risk-increasing medications such as NSAIDs or low-dose aspirin. Assuming a causal role of SSRIs, reported excess gastrointestinal bleedings attributable to SSRI use was reported to be 3.1 per 1000 treatment years, 4.1 per 1000 treatment years among octogenarians and 11.7 per 1000 treatment years among persons with prior upper gastrointestinal bleeding. These non-negligible risks warrant that prescribing doctors consider strategies on the individual level to reduce the likelihood of an upper gastrointestinal adverse event. Patients at particular risk include those with previous ulcers or gastrointestinal bleeding, the elderly and those with certain concurrent illnesses and/or high-risk comedications. Suggested strategies include alternatives to SSRI use, prescribing of less gastrotoxic NSAIDs or co-prescribing of gastroprotective drugs. Patients should be informed about the likelihood of possible upper gastrointestinal bleeding and high-risk patients should be followed closely.
Indexed as
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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.