SSRIs May Increase Risk of Postsurgical Adverse Effects, Study Finds

Selective serotonin reuptake inhibitors (SSRIs) have been known, in the presence of other risk factors, to increase the likelihood of bleeding in some patients. This is probably due to their antiplatelet activity. Now a retrospective study of 530,416 patients at 375 U.S. hospitals finds a slight but significantly increased risk of adverse outcomes following surgery in those taking these antidepressants, said Andrew Auerbach, M.D., M.P.H., of the Division of Hospital Medicine at the University of California, San Francisco, online April 29 in JAMA Internal Medicine.

Following adjustments, patients taking SSRIs had higher odds of dying in the hospital (odds ratio = 1.20), experiencing postoperative bleeding (OR = 1.09), and readmission within 30 days (OR = 1.22) than those not taking these medications. However, absolute differences were small. For instance, 352 or 0.6 percent of patients not taking SSRIs died, compared with 419 or 0.7 percent of those using the medications. “Our results suggest that SSRIs are associated with a range of poorer outcomes after major surgery,” concluded Auerbach and colleagues, who called for a major prospective, randomized trial to determine the best way to manage SSRI use in surgical patients.

To read more about studies assessing potential adverse effects of SSRIs, see Psychiatric News here. For information about use of antidepressants in patients with a wide range of disorders, see American Psychiatric Publishing's The Evidence-Based Guide to Antidepressant Medications. 

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