SSRI Antidepressants Cause Severe Bleeding

Life Threatening Stomach Bleeds Caused by Common SSRI Antidpressants

SSRI antidepressants such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil) cause serious gastrointestinal(GI) bleeding according to a recent Danish study. 

Researchers looked at 3,652 patients admitted to hospitals with a GI bleeding problem then checked their medical records for their use of SSRI drugs.   Recent users (less than 90 days) and past users (over 90 days) suffered a 1.2 fold and 1.9 fold increased risk compared to those who were not on SSRIs. 

Much more worrisome is the greatly increased danger of bleeding with an SSRI plus a so called non-steroidal anti-inflammatory (NSAID) drug like ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn) — a full 8-fold increase.  When you add aspirin to an SSRI and NSAID, the risk of serious GI bleeds shoots up to 28-fold.

BLEEDING PROBLEMS NOT NEW                                                                                                                                                                                                                The effects of these drugs on bleeding have been known for some time, though not quantified quite so accurately as in the Danish study.   Bleeding problems have been documented for years in various medical journals.  These include bruises, nose bleeds, and GI bleeds and bleeding localized to areas other than the GI tract. 

SEROTONIN IN THE BRAIN                                                                                                                                                                                                                    SSRIs prevent the reabsorption of serotonin by nerve cells.  This leaves more serotonin available to act at its receptors.  This effect is believed to account for the mood repairing effects of SSRI antidepressants.  When you think serotonin, think “feel good”, “warm and cozy” and healthy, refreshing sleep.

SEROTONIN IN BLOOD                                                                                                                                                                                                                             SSRIs also prevent the normal reabsorption by blood components called platelets.  Platelets help form blood clots by clumping together.  Serotonin is needed for this to happen in a normal, appropriate way.  SSRIs lower serotonin levels in platelets and disturb this process, which increases the risk of bleeding.

HOW MANY PEOPLE HAVE BEEN KILLED?                                                                                                                                                                                        This dual effect of a drug –a purported benefit in one tissue (brain) and clear danger in another (blood) is a common problem with drugs, which are single molecule agents supposedly intended for one specific target.  But drugs don’t have just one effect, they have multiple effects in different tissues, some of which may be harmful.  These effects, or so called side effects, often remain undiscovered for years after they are allowed on the market by the FDA.  So how many people have been killed by SSRIs?

HOW WELL DO SSRIs WORK?                                                                                                                                                                                                                Recent research shows that overall, SSRIs are no more effective than placebo for treating depression.  The exception to this is for individuals with severe depression, where they can be quite useful.  This tells us that SSRI antidepressants are overprescribed by doctors.  In addition, published research shows that psychiatrists have extremely close financial ties to drug companies — probably closer than any other medical specialist group. 

Given the minimal effectiveness of SSRI antidepressants along with their evident dangers — both spelled out extensively in peer reviewed research  – let us hope that prescribing professionals start exercising more prudence when prescribing SSRIs.

SSRI Antidepressants:  sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro)        SNRIs (same effect): venlafaxine (Effexor, Effexor XR), duloxetine (CYMBALTA), desvenlafaxine (PRISTIQ).  SYMBAX is a combination of fluoxetine and olanzapine, an antipsychotic drug.

For more information see M Dall et all, Clinical Gastroenterology and Hepatology, December 2009