Bleeding risk with antidepressants profoundly influenced by declining renal function

There is a well-known risk for bleeding complications associated with the use of antidepressant drugs. Researchers have now demonstrated that the extent of this risk is influenced adversely by impairment of renal function. Researchers compared patients with chronic kidney disease (CKD; estimated glomerular filtration rate <60 ml min^–1 1.73 m^–2 for ≥3 months), and a comparison group of patients without this diagnosis. The excess risk of GI bleeding associated with SSRIs markedly increased among patients with decreased kidney function, with the risk greatest amongst those with the poorest renal function. In this large population-based study, relative risk of GI bleeding associated with SSRI exposure was approximately 1.7 regardless of renal function, but the excess risk of GI bleeding increased substantially as renal function declined; ranging from 2.0/1000 person years among patients without chronic kidney disease to to 7.9/1000 person years among patients with CKD stage 4/5. Those wanting more detail can read the paper in its entirety here