McGill University, Jewish General Hospital, Department of Psychiatry , Montreal , Canada.
Expert Opin Drug Saf. 2014 Jun;13(6):695-704. doi: 10.1517/14740338.2014.908182. Epub 2014 Apr 9.
Serotonergic antidepressants (SAds) are known to increase bleeding events, with a number of recent studies investigating this risk in surgical settings. Our main objective was to synthesize the current evidence to evaluate the clinical importance of SAd-related bleeding risk in the perioperative period.
A systematic review of MEDLINE, Embase and PsychINFO until November 2013 was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We examined the risk of perioperative bleeding adverse events in SAd users in comparison to controls.
A total of 13 relevant studies were identified across a broad variety of surgical procedures. SAds were associated with an increased risk of perioperative bleeding (odds ratios [ORs] = 1.21 - 4.14) and blood transfusions (ORs = 0.93 - 3.71).
SAds are associated with increased perioperative bleeding events, particularly abnormal bleeding and blood transfusions. From a clinical perspective, the potential bleeding risks of SAds in surgical settings need to be carefully weighed against their psychiatric benefits. Future research will need to investigate potential strategies to mitigate SAd-related bleeding risk in the surgical context.
血清素能抗抑郁药（SAds）已知会增加出血事件，最近有许多研究调查了手术环境中的这种风险。我们的主要目的是综合目前的证据，评估围手术期 SAd 相关出血风险的临床重要性。
我们按照系统评价和荟萃分析的首选报告项目声明，对 MEDLINE、Embase 和 PsychINFO 进行了系统的文献检索，检索时间截至 2013 年 11 月。我们检查了 SAd 使用者与对照组相比围手术期出血不良事件的风险。
在广泛的手术过程中总共确定了 13 项相关研究。SAds 与围手术期出血（比值比 [ORs] = 1.21-4.14）和输血（ORs = 0.93-3.71）风险增加相关。
SAds 与围手术期出血事件增加有关，特别是异常出血和输血。从临床角度来看，SAds 在手术环境中的潜在出血风险需要与它们的精神益处仔细权衡。未来的研究将需要调查在手术环境中减轻 SAd 相关出血风险的潜在策略。
