In a new study from Creighton University, researchers found taking common painkillers alongside antidepressants called selective serotonin reuptake inhibitors (SSRIs) may raise the chances for intestinal bleeding.
They found that those taking SSRIs (such as Celexa, Paxil, Prozac and Zoloft) and pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil and Aleve had an increased risk for gastrointestinal bleeding.
In a review of 10 published studies involving 6,000 patients, the team found when adding SSRIs to patients already on NSAIDs, the odds of developing an upper gastrointestinal bleed increased by 75%.
the increased risk of upper gastrointestinal bleeding is likely due to the interaction of the two types of drugs.
NSAIDs inhibit the production of prostaglandin, which protects the gastrointestinal tract, and SSRIs inhibit the production of platelets, which are needed for clotting. This combination, therefore, increases the risk of bleeding.
The team suggests the risk of upper gastrointestinal bleed by adding an SSRI to an NSAID needs to be discussed between the patient and physician.
When possible, it is best to reduce or discontinue NSAIDs prior to starting an SSRI in order to minimize upper gastrointestinal bleed risk.
Gastrointestinal bleeding can cause vomiting of blood or blood in the stool or black stool.
Some bleeding, however, may be microscopic and not seen; therefore, symptoms of anemia such as fatigue, shortness of breath on exertion or lightheadedness may signal blood loss as well.
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The study was presented at the American College of Gastroenterology meeting. One author of the study is Dr. Syed Alam.
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