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Heart Beat: Antidepressants boost bleeding risk

Heart Beat

Antidepressants boost bleeding risk

A note of caution to people taking Paxil, Prozac, and similar antidepressants: Research finds that these and related drugs, known as selective serotonin reuptake inhibitors (SSRIs), can cause serious bleeding problems.

SSRIs rebalance serotonin levels in the brain, which helps ease depression. But the drugs also affect serotonin levels elsewhere, such as in platelets. These are the sticky cell fragments that play a crucial role in blood clotting.

The trouble isn’t common, affecting fewer than 1 in every 200 people taking these drugs. Yet the findings have special relevance for people with heart disease.

Depression is widespread among heart attack survivors and people with angina, heart failure, erratic heart rhythms, and other types of heart disease. Research since the early 2000s suggesting that SSRI antidepressants not only alleviate depression but may also prevent second heart attacks has made doctors more comfortable prescribing them for people with heart disease. Yet these are the same people who are usually taking other medications that can cause abnormal bleeding, such as aspirin and warfarin.

Most people don’t have any bleeding problems with an SSRI. To be on the safe side, be alert for signs of abnormal bleeding — nosebleeds, shaving cuts that take too long to heal, blood in the stool, and unexplained bruises or blood spots under the skin. If these appear, ask your doctor if it is worth trying a different antidepressant.

Last updated:	August 21, 2006