What issues do I need to consider before prescribing a selective serotonin reuptake inhibitor?
• The most common adverse effects associated with selective serotonin reuptake inhibitors (SSRIs) are gastrointestinal effects (nausea and diarrhoea), central nervous system effects (dizziness, agitation, insomnia, and tremor), and sexual dysfunction [Taylor et al, 2005]. • Observational studies have shown that SSRIs increase the risk of upper gastrointestinal bleeding, probably by altering platelet function [de Abajo et al, 1999; van Walraven et al, 2001; Dalton et al, 2003; Meijer et al, 2004]. This observed increase in risk may also apply to other types of bleeding: • This risk is increased in people who are also taking low-dose aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) [Dalton et al, 2003]. Consider gastroprotection for all people who are prescribed both an SSRI and an NSAID or aspirin [Paton and Ferrier, 2005]. • This increased risk may also apply to very old people or those with a history of gastrointestinal bleeding. Consider using an antidepressant with a low aff
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- What issues do I need to consider before prescribing a selective serotonin reuptake inhibitor?
