ArticleBritish journal of clinical pharmacology2008
Gastro-intestinal haemorrhage risks of selective serotonin receptor antagonist therapy: a new look.
Article in British journal of clinical pharmacology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 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
- Risk of Gastrointestinal Bleeding with Concurrent Use of NSAID and SSRI: A Systematic Review and Network Meta-Analysis.Digestive diseases and sciences · 2023Pooled it
- Pooled it
- Absence of pharmacovigilance signals for bleeding events associated with warfarin-SSRI drug interactions: a comparative analysis of FAERS and CVARD databases.Therapeutic advances in drug safety · 2026Article
- SSRI co-medication with NOAC or VKA does not increase hospitalisation for bleeding: A retrospective nationwide cohort study in Austria 2010-2015.International journal of geriatric psychiatry · 2019Article
- 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
- Antidepressant use and risk of adverse outcomes in people aged 20-64 years: cohort study using a primary care database.BMC medicine · 2018Article
- Use of beta-blockers and risk of serious upper gastrointestinal bleeding: a population-based case-control study.Therapeutic advances in gastroenterology · 2017Article
- Severe potential drug-drug interactions in older adults with dementia and associated factors.Clinics (Sao Paulo, Brazil) · 2016Article
- Use of SSRI, But Not SNRI, Increased Upper and Lower Gastrointestinal Bleeding: A Nationwide Population-Based Cohort Study in Taiwan.Medicine · 2015Observational
- Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease.World journal of gastroenterology · 2014Review
- Bleeding complications and liver injuries during phenprocoumon treatment: a multicentre prospective observational study in internal medicine departments.Deutsches Arzteblatt international · 2013Observational
- Bleeding adverse drug reactions (ADRs) in patients exposed to antiplatelet plus serotonin reuptake inhibitor drugs: analysis of the French Spontaneous Reporting Database for a controversial ADR.European journal of clinical pharmacology · 2012Article
- Article
- Review
- Selective serotonin re-uptake inhibiting antidepressants and the risk of overanticoagulation during acenocoumarol maintenance treatment.British journal of clinical pharmacology · 2011Article
- Antidepressant use and risk of adverse outcomes in older people: population based cohort study.BMJ (Clinical research ed.) · 2011Article
- Bleeding incidence with concomitant use of antidepressants and warfarin.Therapeutic drug monitoring · 2011Article
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 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims(i) To determine the effects of selective serotonin reuptake inhibitors (SSRI) and other classes of antidepressants on upper gastro-intestinal (GI) haemorrhage and (ii) to assess the drug-drug interaction effects of antidepressants and warfarin or clopidogrel on the risk of GI haemorrhage.
methodsThis was a population-based case control study in the General Practice Research Database (GPRD). Cases with a first episode of upper GI haemorrhage between 2000 and 2005 were matched with up to 10 controls. Exposure to the study drugs was defined by a prescription issued in the 90 days before the index date. Rate ratios were estimated using conditional logistic regression.
resultsFour thousand and twenty-eight cases of GI haemorrhage and 40 171 controls were identified. The excess risk of GI haemorrhage with SSRI use was small (Rate Ratio [RR]: 1.3; 95% confidence interval [CI]: 1.1, 1.6) and null with exposure to tricyclic antidepressants (TCAs) (RR 1.0; 95% CI: 0.8, 1.3). The risk of GI haemorrhage was highest with venlafaxine use (RR: 1.9; 95% CI: 1.3, 2.6). There was no drug-drug interaction between warfarin anticoagulation and antidepressant use.
conclusionsThis study supports a small increased risk of upper GI haemorrhage with the use of SSRI antidepressants compared with the older TCA drugs, but to a lesser extent than previously reported due to confounding by alcohol use. The small elevation in risk of GI haemorrhage with SSRI and venlafaxine should be weighed against the therapeutic benefit of their use.
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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.