Antidepressants Linked to Stomach Bleeding

If you are one of the millions of people taking antidepressants to help control or reduce depression, be aware that these drugs may cause gastrointestinal (stomach and intestinal) bleeding. This class of drugs, known as selective serotonin reuptake inhibitors (SSRIs), along with another type of antidepressant called a serotonin and norepinephrine reuptake inhibitor (SNRI), are used to treat depression and may cause stomach ulcers-erosion of the mucous membrane that lines the upper digestive tract.

A Spanish study, published in The Archives of General Psychiatry, and led by authors Francisco de Abajo and Luis Garcia-Rodriguez, reports that people taking SSRIs such as Prozac, Paxil, Celexa and Zoloft or SNRI-Wyeth's Effexor, also called venlafaxine-showed a heightened risk of stomach irritation that included bleeding.

In comparing 1,321 people who had received treatment for upper gastrointestinal (GI) bleeding to 10,000 control patients of the same age and sex who had no bleeding, the study found that 5.3 percent of patients with GI bleeding were taking SSRIs compared to 3 percent of the controls and 1.1 percent with bleeding were taking Effexor (SNRI) compared to 0.3 percent of the control group. The risk factor increased by almost 60 percent for those taking SSRIs and nearly tripled for those taking SNRI, and if you throw NSAIDs in the mix there is nearly a fivefold increase in the risk of GI bleeding. NSAIDs translate to non-steroidal anti-inflammatory drugs, a class of pain relievers that includes ibuprofen, naproxen, and corticosteroids that have known negative effects on the GI tract.

Though the results appear frightening, the risks in general are quite low, with only one in every 2,000 people treated with antidepressants will encounter any sign of gastrointestinal bleeding, but the number increases to one in every 250 people when NSAID drugs are added to the equation. Taking acid-suppressing drugs such as Nexium and Prilosec help cut the risk considerable-AstraZeneca Plc, the maker of these drugs, helped sponsored this study. Dr. Ewald Horwath, professor of psychiatry, epidemiology and public health at the University of Miami, Miller School of Medicine, said "The risk of discontinuing antidepressants and getting depression and its consequences are much greater than this drug."

Although there has been some controversy about the significance, this is the best study to date to look at this side effect of antidepressant. Dr. Joseph White, associate professor of internal medicine at Texas A&M Health Science Center College of Medicine and chief of laboratory medicine at Scott & White Clinic, said "The risk probably does appear real, but it's slight, unless you're taking concomitant medications. If you're taking these antidepressants along with other medications, keep it in mind and discuss with your physician."