Short-Term Use of Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding

Wang, Yen‐Po; Chen, Yung Tai; Tsai, Chia Fen; Li, Szu Yuan; Luo, Jiing Chyuan; Wang, Shuu Jiun; Tang, Chao Hsiun; Liu, Chia Jen; Lin, Han Chieh; Lee, Fa Yauh; Chang, Full Young; Lu, Ching Liang

doi:10.1176/appi.ajp.2013.12111467

Cited by 78 publications

(73 citation statements)

References 36 publications

(48 reference statements)

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“…Approximately half of all patients started on these agents experience GI side effects mainly in the first few days/weeks following treatment initiation [29,30]. Short-term SSRI use (7-28 days) is significantly associated with upper GI bleeding, suggesting that the same precautions that are used with nonsteroidal anti-inflammatory drugs and aspirin are appropriate [31]. Some studies have found nausea and vomiting to be one of the most common reasons for treatment discontinuation [32,33].…”

Section: Gastrointestinalmentioning

confidence: 99%

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The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature

Carvalho

Sharma²,

Brunoni³

et al. 2016

Psychother Psychosom

485

324

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Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.

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Section: Gastrointestinalmentioning

confidence: 99%

“…The use of SSRIs could be associated with an increased risk of upper GI bleeding [31,127]. The overall risks are substantially higher among individuals on concomitant use of nonsteroidal anti-inflammatory agents [127,128].…”

Section: Bleedingmentioning

confidence: 99%

The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature

Carvalho

Sharma²,

Brunoni³

et al. 2016

Psychother Psychosom

485

324

View full text Add to dashboard Cite

show abstract

“…Administration of these antidepressants has been also successfully used as a treatment for gastrointestinal diseases, such as motility disorder and gastrointestinal bleeding [92,119], confirming comorbidity of these disorders, but exert a puzzling effect on the intestinal bacterial composition.…”

Section: Gut Microbiota and Serotonin Productionmentioning

confidence: 99%

Role of Microbiota and Tryptophan Metabolites in the Remote Effect of Intestinal Inflammation on Brain and Depression

Waclawiková¹,

Aidy²

2018

Preprint

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The human gastrointestinal tract is inhabited by trillions of commensal bacteria collectively known as the gut microbiota. Our recognition of the significance of the complex interaction between the microbiota, and its host has grown dramatically over the past years. A balanced microbial community is a key regulator of the immune response, and metabolism of dietary components, which in turn, modulates several brain processes impacting mood and behavior. Consequently, it is likely that disruptions within the composition of the microbiota would remotely affect the mental state of the host. Here, we discuss how intestinal bacteria and their metabolites can orchestrate gut-associated neuroimmune mechanisms that influence mood and behavior leading to depression. In particular, we focus on microbiota-triggered gut inflammation and its implications in shifting the tryptophan metabolism towards kynurenine biosynthesis while disrupting the serotonergic signaling. We further investigate the gaps to be bridged in this exciting field of research in order to clarify our understanding of the multifaceted crosstalk in the microbiota-gut-brain interphase, bringing about a novel microbiota-targeted therapeutics for mental illnesses.

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“…The accuracy of diagnosis of major diseases in the NHIRD has been validated in several studies. [17][18][19] All information that could potentially identify an individual patient was encrypted. Confidentiality of data was maintained in accordance with the data regulations of the Bureau of National Health Insurance and the National Health Research Institute.…”

Section: Data Sourcesmentioning

confidence: 99%

Short-Term Use of Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding

Cited by 78 publications

References 36 publications

The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature

The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature

Role of Microbiota and Tryptophan Metabolites in the Remote Effect of Intestinal Inflammation on Brain and Depression

Risk of Cancer in Patients with Cholecystitis: A Nationwide Population-based Study

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