Selective serotonin reuptake inhibitors (SSRIs) – among the most widely prescribed antidepressant medications – are associated with increased risk of bleeding, transfusion, hospital readmission and death when taken around the time of surgery, according to an analysis led by researchers at UC San Francisco and Baystate Medical Center in Springfield, Mass.
The scientists looked at the medical records of more than 530,000 patients who underwent surgery at 375 U.S. hospitals between 2006 and 2008. Their results will be published on April 29 in JAMA Internal Medicine.
"There have been small studies that suggested there was a problem, but it has never been well-proven," said lead author Andrew D. Auerbach, MD, MPH, a UCSF professor of medicine. "With this huge data set, we feel confident in saying that SSRIs are associated with about a 10 percent increased risk for these adverse outcomes."
The study authors noted that patients on SSRIs are more likely to have conditions that in themselves increase surgical risk, such as obesity, chronic pulmonary disease and depression.
To address the question of whether these factors might have accounted for the differences in outcomes, they retrospectively matched patients who had taken SSRIs with patients who were not taking the drugs. After matching and controlling for variables such as age, gender, medical condition and depression, they found that patients on SSRIs still were at increased risk.
The scientists also looked at whether the increased risk could be accounted for by patients receiving SSRIs for the first time before surgery. "This was not the case," said Auerbach. "These drugs are almost never used acutely. They are prescribed for chronic conditions such as depression, almost always for long-term use."
The study was not designed to look at possible causes for the increased risk. However, noted Auerbach, SSRIs are known to interfere with the functioning of platelets – blood cells that play a crucial role in blood clotting. In turn, platelet dysfunction can lead to excess bleeding.
Auerbach cautioned that since the study was retrospective, "a prospective observational study, in which patients are randomly assigned to take SSRIs around the time of surgery, is still needed."
He said that while it would be premature to advise patients not to take SSRIs before surgery, "it's definitely worth discussing with your surgeon or primary care physician."
Co-authors of the paper are Eric Vittinghoff, PhD and Judith Maselli, MSPH, of UCSF; Penelope S. Pekow, PhD, of the University of Massachusetts Amherst and Baystate Medical Center; John Q. Young, MD, of UCSF; and senior author Peter K. Lindenauer, MD, MSc of Baystate Medical Center and Tufts University.
The study was supported by funds from the National Heart, Lung and Blood Institute (K24HL098372).
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Juliana Bunim | EurekAlert!
Finnish research group discovers a new immune system regulator
23.02.2018 | University of Turku
Minimising risks of transplants
22.02.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg
A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.
In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...
A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.
By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...
Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...
For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.
In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...
Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale
Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...
15.02.2018 | Event News
13.02.2018 | Event News
12.02.2018 | Event News
23.02.2018 | Physics and Astronomy
23.02.2018 | Health and Medicine
23.02.2018 | Physics and Astronomy