There is an association between selective serotonin reuptake inhibitor use and uncomplicated peptic ulcers: a population-based case-control study.
BACKGROUND
Persons who use serotonin reuptake inhibitors (SSRIs) seem to be at increased risk of having serious upper gastrointestinal bleeding. In vitro studies have shown that SSRIs inhibit platelet aggregation. It remains unknown if SSRIs have a direct ulcerogenic effect.


OBJECTIVE
To investigate if there is a possible association between use of SSRIs and uncomplicated peptic ulcers.


METHODS
A population-based case-control study was conducted in the county of Funen, Denmark, using local prescription database and patient register. The 4862 cases all had a first diagnosis of uncomplicated peptic ulcers from 1995 to 2009. Controls (n = 19 448), matched for age and gender, were selected by risk-set sampling.


RESULTS
The adjusted odds ratios (OR) of uncomplicated peptic ulcers among current, recent and past users of SSRIs were 1.50 (95% CI 1.18-1.90), 1.56 (95% CI 0.98-2.49) and 1.32 (95% CI 1.08-1.61). There was no association with tricyclic antidepressants [OR 0.94 (95% CI 0.65-1.35)]. The adjusted OR for the SSRI-uncomplicated peptic ulcers association was 0.76 (95% CI 0.46-1.25) among users of proton pump inhibitors.


CONCLUSIONS
Use of SSRI is associated with uncomplicated peptic ulcers, possibly by some effect on the healing process. We cannot exclude some effects of residual confounding or bias by frequent physician contact.
University of Southern Denmark, Odense C, Denmark. mdall@health.sdu.dk
M
M
Dall
O B
OB
Schaffalitzky de Muckadell
A T
AT
Lassen
J
J
Hallas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003718:Denmark; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000139:chemically induced*; D012307:Risk Factors; D012702:Serotonin Antagonists / Q000009:adverse effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D055815:Young Adult
D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors