JAMA Study: Perioperative SSRI Use Associated with Increased Adverse Event Risks

SSRI-Adverse_EffectsA new study found that patients taking selective serotonin reuptake inhibitors (SSRIs) during the perioperative period (from hospitalization admission to discharge) were at increased risks for suffering an adverse event. The study appears in the April 29, 2013 issue of JAMA Internal Medicine, said Drug Safety Monitor.

The researchers analyzed the adverse events associated with SSRI use when prior research revealed that analysis of single hospital sites showed an increased rate of adverse events following surgery, Drug Safety Monitor explained.

The retrospective study involved 530,416 surgery patients aged 18 years or older; records from 375 hospitals from January 1, 2006 to December 31, 2008 were reviewed and the researchers utilized pharmacy data to determine if patients used SSRIs pre-surgery, during surgery, or post-surgery, wrote Drug Safety Monitor. The researchers discovered that patients with perioperative SSRI use were at increased risk for in-hospital mortality, bleeding, and re-admission at 30 days.

SSRIs include drugs such as Celexa, Desyrel, Lexapro, Luvox, Luvox CR, Oleptro, Paxil, Paxil CR, Pexeva, Prozac, Sarafem, Serzon, Symbyax, Vilbryd, and Zoloft). SSRIs are indicated for the treatment of major depressive disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, anxiety disorders, bulimia nervosa, and premenstrual dysphoric disorder (PMDD), and are typically used in the treatment of depression. These medications have different indications and active ingredients; not all SSRIs treat the same conditions, Drug Safety Monitor noted. It is believed that SSRIs increase serotonin levels in the brain.

U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) data from November 1, 1997 to August 27, 2012 was aggregated and standardized by the AdverseEvent RxFilter process, Drug Safety Monitor explained. The researchers identified 100,236 serious adverse events in which an SSRI was indicated as the primary suspect medication. Drug Safety Monitor said that the most commonly reported side effects included dizziness, nausea, and headache. In cases in which an SSRI was indicated as the primary suspect, the team identified 22,724 hospitalizations and 8,252 patient deaths.

We recently wrote that a study found an increased risk of developing an autism spectrum disorder (ASD) in children whose mothers took specific antidepressant medications, including SSRIs. This was the second study in two years to associate antidepressant use during pregnancy with an increased likelihood of exposed children being diagnosed with autism.

We previously wrote that another study suggested that there is too much of a risk taking SSRIs during pregnancy, including potential increased risks for miscarriage, pre-term births, neonatal health complications, and long-term neurobehavioral abnormalities including autism.

Prior to that, we wrote that a growing body of research linked SSRIs to birth defects and other issues when used by pregnant women, especially in the early months of pregnancy when many women don’t realize they are pregnant. One study published by researchers at Sweden’s Karolinska Institute found that taking an SSRI antidepressant during pregnancy was associated with a two-fold increased risk of neonatal pulmonary hypertension (PPHN). Another report published in the Archives of General Psychiatry found that babies exposed to SSRI antidepressants before birth exhibit reduced head growth at birth, and are more likely to be born prematurely.

Researchers at Canada’s McMaster University discovered that antidepressants that impact levels of serotonin in the brain can cause side effects related to any bodily process normally regulated by serotonin. Some possible side effects include birth defects in infants; sexual dysfunction, and problems with sperm development in adults; diarrhea, constipation, indigestion, bloating, and other digestive problems; and abnormal bleeding and stroke in the elderly.

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