Taking a combination of antidepressants and painkillers commonly used by arthritis sufferers has been linked to an increased risk of bleeding, scientists have warned.
Researchers said they are concerned that antidepressants may interact with non-steroidal anti-inflammatory drugs (NSAIDs) to increase the risk of bleeding inside the skull (intracranial haemorrhage) soon after starting treatment.
The study, which is published in the BMJ, saw a team of researchers based in Korea compare the risk of bleeding among patients treated with antidepressants with and without NSAIDs.
Using the Korean nationwide health insurance database, they looked at four million people who were prescribed antidepressants for the first time between 2009 and 2013.
NSAID prescriptions were obtained and hospital records were used to identify time to first admission with intracranial haemorrhage within 30 days of a new prescription.
They found that compared with use of antidepressants alone, combined use of antidepressants and NSAIDs was associated with a substantially increased bleeding risk, with males more likely to be affected.
They said their findings show that extra vigilance is needed when taking both drugs together.
They found no statistically meaningful differences in risk of bleeding between different types of antidepressant drugs or with age.
"The addition of NSAIDs to antidepressant treatment increased the risk of intracranial haemorrhage within 30 days of the combination starting, especially in men," the authors from Seoul National University College of Medicine said.
"This result adds to evidence confirming the increase of risk with combination use of antidepressants and NSAIDs."
Professor Simon Maxwell, a clinical pharmacologist at the University of Edinburgh, said the study was "interesting", but there are a number of difficulties in interpretation and applicability to the UK.
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