SSRIs may interact with antiplatelet medications given after an acute MI, raising the risk of bleeding, a large study suggests.
Compared with patients taking aspirin alone, patients who took both aspirin and an SSRI had a 42% increased risk of bleeding (CI 1.08-1.87).
Compared with patients taking aspirin and clopidogrel alone, those who took both drugs together with an SSRI had a 57% increased risk of bleeding (CI 1.07-2.32).
Writing in the Canadian Medical Association Journal, the authors concluded that clinicians must “weigh the benefits of SSRI therapy against the risk of bleeding in patients with major depression following acute MI”.
SSRI use itself had been associated with increased risk of bleeding, but may also worsen bleeding caused by aspirin and clopidogrel, they wrote.