Episode 276: 275. Do SSRI Increase The Rate Of Bleeding With Anticoagulants?

This translates into an absolute excess risk of ≈9 events per 1000 person-years or 1 per 110 person years. Sad differently if you treat 110 people for 1 year with a doac and an SSRI you will have one more bleed that requires hospitalization or death than if there was no SSRI.

This Risk was similar for various types of bleeding (e.g., intracranial, gastrointestinal) and did not vary with potency of SSRI.

In patients with strong indications for both drugs, the relatively small absolute excess risk might be acceptable. However, in patients for whom the indication for either the SSRI or the anticoagulant is marginal, the excess bleeding risk might be a reason to avoid prescribing both drugs together.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816687