Be Careful Using Fluoxetine or Fluvoxamine With Warfarin

You'll hear that combining antithrombotics with SSRI or SNRI antidepressants has an additive effect on bleeding.

SSRIs and SNRIs alone can increase bleeding risk...probably by inhibiting serotonin reuptake into platelets.

One more A fib patient per year will have a major bleed for every 100 using warfarin plus an SSRI or SNRI...compared to warfarin alone.

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