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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Mark H. on February 12, 2001, at 16:30:57
Dear Friends,
About seven or eight weeks ago, I started taking one or two enteric coated low-dosage (81 mg) aspirin a day, based on reports that doing so can help prevent heart attacks and strokes. I did so without bothering to research potential interactions with the five medications I take daily and without checking with my doctor. As stupid as that sounds, it just never occurred to me to think of aspirin as a "real drug."
To make a long story short, my stomach hurts, my knees hurt, I have bruises on both legs from bumps I don't even remember, and my AST and GGT are mildly elevated, which apparently suggests liver irritation. I'm just glad I thought to stop before several more months (or years) went by.
While there is no proof that any of the above are the result of my taking aspirin, just last week there was an article in the paper about SSRIs and aspirin increasing each other's tendency to cause bleeding in the digestive tract. Who knows what other interactions might be involved?
The lesson is so simple I'm embarrassed to have forgotten it when it comes to something as common as aspirin: check with your doctor, do your research.
Best wishes,
Mark H.
Posted by Sunnely on February 12, 2001, at 22:26:34
In reply to Caution on Aspirin with SSRIs, Maybe Other ADs, posted by Mark H. on February 12, 2001, at 16:30:57
Increased bleeding tendency from aspirin is well-documented in the literature. Not only that it can irritate the stomach which could lead to bleeding ulcers, but it also has a anti-platelet (blood-thinning) effect which could lead to other forms of bleeding tendencies.
There have been anecdotal reports that SSRIs also cause increased bleeding tendencies. The adverse reactions frequently reported include easy bruising, epistaxis (spontaneous nose bleeding), and rectal bleeding. Other bleeding tendencies reported include heavy menstrual flow and other menstrual problems, gastric ulcerations with hemorrhage, petechiae (small reddish skin spots), and melena (black stools).
The mechanism as to how SSRIs increase bleeding tendencies may be related to their effect on serotonin. Under normal circumstances, platelets (blood particles responsible for clotting) release serotonin at the site of blood vessel tears, leading to further platelet aggregation and vasodilation (blood vessels enlarge). This permits sealing of the tear stopping the bleeding. It appears that the SSRis block the reuptake of serotonin into the platelets which lead to reduced amount of serotonin released by the platelets into the site of bleeding.
Indeed the combination of SSRI + aspirin puts one at risk for increased bleeding tendencies and your caution should be taken seriously.
===============================================================
> Dear Friends,
>
> About seven or eight weeks ago, I started taking one or two enteric coated low-dosage (81 mg) aspirin a day, based on reports that doing so can help prevent heart attacks and strokes. I did so without bothering to research potential interactions with the five medications I take daily and without checking with my doctor. As stupid as that sounds, it just never occurred to me to think of aspirin as a "real drug."
>
> To make a long story short, my stomach hurts, my knees hurt, I have bruises on both legs from bumps I don't even remember, and my AST and GGT are mildly elevated, which apparently suggests liver irritation. I'm just glad I thought to stop before several more months (or years) went by.
>
> While there is no proof that any of the above are the result of my taking aspirin, just last week there was an article in the paper about SSRIs and aspirin increasing each other's tendency to cause bleeding in the digestive tract. Who knows what other interactions might be involved?
>
> The lesson is so simple I'm embarrassed to have forgotten it when it comes to something as common as aspirin: check with your doctor, do your research.
>
> Best wishes,
>
> Mark H.
Posted by Sulpicia on February 13, 2001, at 10:23:11
In reply to Caution on Aspirin with SSRIs, Maybe Other ADs, posted by Mark H. on February 12, 2001, at 16:30:57
> Timely post! With flu season starting we had a mess on another board where a small child on SSRIs took a walloping dose of Robitussin. The dextromethorphan, a potent serotonin reuptake inhibitor itself, combined with his meds to really knock the poor kid on his butt.
My favorite med checker is Dr.Koop.com -- prescription, OTC, and food interactions, AND many links to the articles cited in the footnotes.
S.
Posted by Pandora on February 17, 2001, at 3:13:03
In reply to Re: Caution on Aspirin with SSRIs, Maybe Other ADs » Mark H. , posted by Sulpicia on February 13, 2001, at 10:23:11
Just read a blurb in Reader's Digest ("News in Medicine") about aspirin and other NSAIDs (Advil, etc) and the increased risk of bleeding when taking these drugs with SSRIs. Tylenol, it was reported, does not have this risk, so at least we still have something to take safely for a headache! : )
This is the end of the thread.
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