Secondary to their antidepressive effect, selective serotonin reuptake inhibitors (SSRI) also lead to a diminished platelet aggregation, which results in an increased risk of bleeding. This adverse effect is added to the therapeutic effects of antiplatelet drugs. Furthermore, combination with nonsteroidal antirheumatic drugs (NSAID) increases the risk of bleeding, particularly in the gastrointestinal tract. Given the widespread use of SSRI, antiplatelet drugs and NSAID, pharmacists and doctors should turn their attention to bleeding as adverse effect and interaction, respectively.
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