Is continuing SSRIs before surgery associated with an increased bleeding and death?

A recent study in JAMA Internal Medicine using hospital billing data to conduct an observational cohort study evaluated the association between perioperative use of SSRIs and various health outcomes. SSRI use compared with nonuse was associated with an increased risk of bleeding (incidence of 2.7 v 2.5%). However, this association was not robust to various sensitivity analyses, such as comparing SSRI use with the use of other antidepressants. Other observational studies in nonsurgical patients have identified similar associations between SSRI use and bleeding, although these studies had similar limitations. Currently, there remains uncertainty about whether SSRI use is associated with an increased risk of perioperative bleeding, and the absolute magnitude of such risks are likely to be small if they indeed exist.

There is no clear clinical action given the current level of evidence.

Reviewed by James Floyd MD MS

Link to abstract in JAMA Internal Medicine

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