Increased Risk of Acute Gastrointestinal Bleeding When Taking Both SSRIs and NSAIDs

Long-term use of selective serotonin re-uptake inhibitors, or SSRIs, increases the risk of gastrointestinal bleeding to a degree similar to that caused by regular use of non-steroidal anti-inflammatory drugs (NSAIDs).  These findings, which come from a new Northwestern University Medical School report, were first presented on May 16, 2005 during Digestive Diseases Week meetings. 

In more detail, the report was based upon a study involving 549 patients who had been admitted to various hospitals for acute gastrointestinal bleeding.  Researchers affiliated with Northwestern’s Medical School reviewed the medical records for these patients to determine which prescription drugs were used in the time period leading up to the subject admission.  The underlying study was sponsored by TAP Pharmaceuticals Products, Inc., a U.S. joint venture of Japan’s Takeda Pharmaceutical Co. Ltd. and Abbott Laboratories Inc.  As a matter of disclosure, it should be pointed out that TAP Pharmaceuticals is the company which makes Prevacid, a heartburn drug.

Eli Lilly and Co., which makes Prozac — one brand name drug in the SSRI category — has commented on the report and its findings.  In relevant part, Eli Lilly said that Prozac users are already being cautioned about the possibility of acute gastrointestinal bleeding insofar that such bleeding is currently listed as a potential side effect of Prozac use.  Notably, the Northwestern Medical School report presented in May 2005 did not name any specific brand names of the several drugs in the SSRI category.

Dr. Michael Jones, the Northwestern report’s chief author, provided some observations following its presentation at the Digestive Diseases Week meetings.  "While more research needs to be conducted … physicians must closely monitor for this serious adverse event, especially in patients who are taking both SSRIs and NSAIDs", Dr. Jones said.  More generally, he added: "This is a potent example of the need for doctors to be particularly conscious about potential side effects when prescribing multiple medications for their patients."

(Posted by: Tom Lamb)