The Pharmaceutical Journal
Vol 273 No 7328 p807
4 December 2004

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Increase in bleeding risk for some antidepressants

Antidepressants that exhibit a high degree of serotonin reuptake inhibition, such as the selective serotonin reuptake inhibitors fluoxetine and paroxetine, are associated with a greater risk of abnormal bleeding than other antidepressants, say researchers (Archives of Internal Medicine 2004;164:2367).

They analysed data collected from 64,000 patients who had received a new prescription for an antidepressant. There were 196 cases of abnormal bleeding and the risk of being admitted to hospital increased with the use of drugs providing intermediate and high degrees of serotonin reuptake inhibition (twice as likely and 2.6 times as likely, respectively).

Antidepressants with a low and intermediate degree of serotonin reuptake inhibition include mirtazapine and venlafaxine (Efexor), respectively. The researchers explain that SSRIs may limit the uptake of blood serotonin by platelets, reducing aggregation.