Use of Selective Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding: A Systematic Review and Meta-analysis.

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Use of Selective Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding: A Systematic Review and Meta-analysis.

Clin Gastroenterol Hepatol. 2014 Jun 30;

Authors: Jiang HY, Chen HZ, Hu XJ, Yang W, Deng M, Zhang YH, Ruan B

Abstract
BACKGROUD & AIMS: Selective serotonin reuptake inhibitors (SSRIs) are used to treat various psychiatric disorders. However, there are concerns that SSRIs increase risk for upper gastrointestinal bleeding (UGIB).
METHODS: We performed a systematic review and meta-analysis of controlled observational studies to determine whether SSRI use affects risk for UGIB. Our analysis included all observational studies that compared UGIB development among patients receiving SSRIs versus no treatment. We calculated pooled odds ratios (ORs) using random-and fixed effects model.
RESULTS: A total of 22 studies (6 cohort and 16 case-control studies) involving over 1,073,000 individuals were included in our meta-analysis. In comparing SSRI users with patients who had not taken SSRIs, the odds for developing UGIB were 1.55 fold higher (odds ratio [OR] =1.55, 95% confidence interval [CI]=1.35-1.78). In subgroup analyses, the association was greatest for patients who received concurrent therapy with non-steroid anti-inflammatory or antiplatelet drugs; we found no significant increase in the risk of developing UGIB among patients receiving concurrent acid-suppressing drugs.
CONCLUSIONS: SSRI use associated with an almost 2-fold increase in the risk of developing UGIB-especially among patients at high risk for GI bleeding (concurrent use of non-steroid anti-inflammatory or antiplatelet drugs). This risk might be significantly reduced by concomitant use of acid-suppressing drugs.

PMID: 24993365 [PubMed - as supplied by publisher]

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