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Several observational studies have demonstrated an association between use of selective serotonin reuptake inhibitors (SSRIs) and upper gastrointestinal bleeding (JW Nov 19 1999). The presumed mechanism is depletion of serotonin from platelets, resulting in impaired platelet function.
In this case-control study, researchers analyzed data from a U.K. general practice database; they compared 1321 patients with upper GI bleeding and 10,000 age- and sex-matched controls. Case patients were more likely than controls to be current users of SSRIs (5.3% vs. 3.0%); excess risk for GI bleeding after SSRI exposure was significant after adjustment for potential confounding variables (adjusted odds ratio, 1.6). An interaction between SSRIs and nonsteroid…