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By Rajnish Mago, MD (bio)
Question from a Member:
Do you recommend that all patients on chronic NSAIDs not take SSRI medications? If not, what do we tell them/ what warnings or precautions do we give patients?
Fortunately, it is not common for patients to be on chronic treatment with non-steroidal anti-inflammatory drugs like ibuprofen, diclofenac, aspirin, and so on. Most patients use these medications on an as-needed basis. I sometimes see patients with rheumatoid arthritis or cervical spondylosis
No, since the absolute risk of bleeding from SSRIs is small, we don’t recommend that all patients on chronic treatment with NSAIDs not take NSAIDs. But, we should encourage acetaminophen whenever possible, monitor for clinical signs of bleeding, and prescribe a proton pump inhibitor for as long as the person is taking the NSAID.
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