Antidepressants Such as Prozac Can Cause Intestinal Bleeding

SSRIs are an interesting drug class.

While they’re one of the most frequently prescribed drugs to treat depression, the exact way they work isn’t understood.

It’s believed that they limit the reabsorption, or reuptake, of serotonin into a cell (hence their name), which increases serotonin levels.

Higher serotonin levels have been associated with a higher sense of well-being, so it may not be surprising that these drugs are often used to combat depression.

Other uses for these relatively low-cost drugs include treating anxiety disorders, obsessive-compulsive disorders, post-traumatic stress disorders, and certain sexual disorders.

But the list of side effects associated with SSRIs is long enough to make any prospective patient think twice.

One of the more common side effects of SSRIs — and a primary reason many patients discontinue their use — is sexual dysfunction in both men and women.

Other side effects include serotonin syndrome, which can, in rare and extreme cases, be deadly.

Finally, there are the ways that SSRIs affect bleeding. When combined with anticoagulants or antiplatelet drugs (such as aspirin), there’s an increased risk of gastrointestinal (GI) bleeding.

Yuet said physicians and pharmacists are generally well aware of this risk, even if many patients tend to view SSRIs as benign.

“There are several over-the-counter medications known to increase bleeding risk, which are potentially dangerous when administered with SSRIs,” she explained. “Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and fish oil. Prescription medications such as warfarin (Coumadin) and clopidogrel (Plavix) will increase bleeding risk as well.”

The prevalence of SSRIs makes this research timely.

In her review, Yuet notes that almost 13 percent of Americans aged 12 and older take an antidepressant of some kind.

Prevalence has also increased. In 1999, less than 8 percent of people in the United States took antidepressants. By 2014, that percentage had increased to more than 12 percent.