ArticleBMJ open2012
Incident user cohort study of risk for gastrointestinal bleed and stroke in individuals with major depressive disorder treated with antidepressants.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Risk of Intracranial Hemorrhage Associated with the Use of Antidepressants Inhibiting Serotonin Reuptake: A Systematic Review.CNS drugs · 2018Pooled it
- Antidepressant use and risk of coronary heart disease: meta-analysis of observational studies.British journal of clinical pharmacology · 2014Pooled it
- Risk score to predict gastrointestinal bleeding after acute ischemic stroke.BMC gastroenterology · 2014Trial
- Escitalopram-induced epistaxis: A case report.Journal of Taibah University Medical Sciences · 2021Article
- Degree of serotonin reuptake inhibition of antidepressants and ischemic risk: A cohort study.Neurology · 2019Article
- The use of electronic health records for psychiatric phenotyping and genomics.American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics · 2018Review
- Agomelatine in the treatment of mild-to-moderate depression in patients with cardiovascular disease: results of the national multicenter observational study PULSE.Neuropsychiatric disease and treatment · 2017Article
- Antidepressant Medication Use and Its Association With Cardiovascular Disease and All-Cause Mortality in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.The Annals of pharmacotherapy · 2016Article
- Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database.BMJ (Clinical research ed.) · 2016Observational
- Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system.Molecular psychiatry · 2015Article
- Validation of electronic health record phenotyping of bipolar disorder cases and controls.The American journal of psychiatry · 2015Article
- Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States.BMJ (Clinical research ed.) · 2013Article
- Similar risk of depression and anxiety following surgery or hospitalization for Crohn's disease and ulcerative colitis.The American journal of gastroenterology · 2013Article
- Psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease.Alimentary pharmacology & therapeutics · 2013Article
- QT interval and antidepressant use: a cross sectional study of electronic health records.BMJ (Clinical research ed.) · 2013Article
- Antidepressant response in patients with major depression exposed to NSAIDs: a pharmacovigilance study.The American journal of psychiatry · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo examine the association between exposure to newer antidepressants and risk of gastrointestinal (GI) and other bleeding complications among individuals with major depressive disorder (MDD).
designThis study uses an incident user cohort design to compare associations between incidence of vascular/bleeding events and the relative affinity (low, moderate or high) of the antidepressant for the serotonin transporter during an exposure risk period for each patient.
settingNew England healthcare system electronic medical record database.
participants36 389 individuals with a diagnosis of MDD and monotherapy with a selective serotonin reuptake inhibitor, serotonin-norepinephrine reuptake inhibitor or other new-generation antidepressant were identified from among 3.1 million patients in a New England healthcare system. PRIMARY AND SECONDARY OUTCOME MEASURES: Rates of bleeding or other vascular complications, including acute liver failure, acute renal failure, asthma, breast cancer and hip fractures.
results601 GI bleeds were observed in the 21 462 subjects in the high-affinity group versus 333 among the 14 927 subjects in the lower affinity group (adjusted RR: 1.17, 95% CI 1.02 to 1.34). Similarly, 776 strokes were observed in the high-affinity group versus 434 in the lower affinity treatment group (adjusted RR: 1.18, 95% CI 1.06 to 1.32). No significant association with risk for a priori negative control outcomes, including acute liver failure, acute renal failure, asthma, breast cancer and hip fractures, was identified.
conclusionsUse of antidepressants with high affinity for the serotonin transporter may confer modestly elevated risk for GI and other bleeding complications. While multiple methodologic limitations must be considered, these results suggest that antidepressants with lower serotonin receptor affinity may be preferred in patients at greater risk for such complications.
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.