ASPIRIN AND SSRIS
The SSRIs may increase the risk of upper gastrointestinal bleeding and the risk appears to be further increased by concurrent aspirin. The overall evidence for an increased risk of bleeding when giving an SSRI with antiplatelet-dose aspirin is conflicting, with some studies demonstrating an increased risk and others suggesting no additional antiplatelet effect occurs.
The manufacturers of the SSRIs warn that patients should be cautioned about the concurrent use of aspirin. Alternatives such as paracetamol (acetaminophen), or less gastrotoxic NSAIDs such as ibuprofen may be considered, but if the combination of an SSRI and NSAID cannot be avoided, prescribing of gastro- protective drugs (such as proton pump inhibitors) should be considered, especially in elderly patients or those with a history of gastrointestinal bleeding.
The manufacturers of the SSRIs warn that patients should be cautioned about the concurrent use of aspirin. Alternatives such as paracetamol (acetaminophen), or less gastrotoxic NSAIDs such as ibuprofen may be considered, but if the combination of an SSRI and NSAID cannot be avoided, prescribing of gastro- protective drugs (such as proton pump inhibitors) should be considered, especially in elderly patients or those with a history of gastrointestinal bleeding.