There is an increased risk of bleeding and stroke with newer antidepressants, which have a ‘high’ affinity for the serotonin transporter. Doctors should be careful about prescribing newer antidepressants to patients who have a high risk of bleeding.
A study looked at the medical records of 36,000 patients diagnosed with major depressive disorder who took serotonin transporter inhibitors (SSRIs) as monotherapy, and the frequency of bleeding complications (particularly gastrointestinal bleeds and strokes) over a nineteen year period.
SSRIs were categorized into three groups – ‘high’, ‘moderate’ or ‘low’ affinity for the serotonin transporter. Newer generation antidepressants have a high affinity. Patients with multiple prescriptions and those on tricyclic antidepressants or monoamine oxidase inhibitors were not included in the study.
Out of the 21,000 patients in the high-affinity group there were more than 600 bleeds, compared with 333 bleeds among the 15,000 patients in the low affinity group, and this equated to a risk ratio of 1.17. Stroke risk was also higher in the high affinity group when compared with the low affinity group, with a risk ratio of 1.18.
Dr. Patience Gallagher, the head of the study stated “Our results add to a growing body of evidence that some newer antidepressants may be associated with elevated risks of gastrointestinal bleeding and stroke,” and “If confirmed by further investigation, it may be possible to achieve these benefits while minimizing risk by selecting antidepressants with lesser affinity for serotonin transporter.”
Source – Pulsetoday.co.uk