People who take the blood thinner warfarin as well as a certain class of antidepressants that includes Zoloft and Paxil may have a higher risk of uncontrolled bleeding, according to a new study presented at the American Heart Association’s annual meeting in early November.
Patients taking warfarin and a selective serotonin reuptake inhibitor (SSRI), such as Celexa, Paxil, Prozac and Zoloft, were at a 60 percent higher risk of major hemorrhage compared to warfarin patients who were not taking an SSRI, based on an analysis of 9,200 patients.
The medical researchers, led by Dr. Gene Quinn of the University of California, San Francisco, who did the study set out to understand the interaction between warfarin, SSRIs and major bleeding events. To do so, Quinn analyzed the health records of a large group of patients with atrial fibrillation who were taking warfarin.
Warfarin has been prescribed for decades to help prevent dangerous blood clots that lead to strokes in patients with certain heart rhythm abnormalities. Like other blood thinners, warfarin has a recognized risk of bleeding.
Selective serotonin reuptake inhibitors are widely prescribed medications for treatment of depression. But previous studies have suggested SSRIs also may increase the risk of bleeding.
To do their analysis, the researchers divided the warfarin users into three groups: those who were taking no antidepressants, those who were taking warfarin and SSRIs and those who were taking warfarin and an older class of antidepressants called tricyclic antidepressants.
When comparing the bleeding risks in the three groups, Dr. Quinn said, the researchers found there was a 60 percent higher risk of major hemorrhage in patients who were taking SSRIs and warfarin versus those who weren’t taking an SSRI, according to an article in U.S. News & World Report’s HealthDay. There was no statistically significant difference in risk for patients taking the older class of antidepressants, suggesting the side effect was for SSRIs specifically rather than all antidepressants.
The researchers said patients taking both warfarin and Zoloft, Paxil or another SSRI should be monitored by their doctors, but should not stop taking their antidepressant without consulting their doctor.
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