Association between selective serotonin and serotonin-noradrenaline reuptake inhibitor therapy and hematuria

Nord J Psychiatry. 2023 Jan;77(1):31-35. doi: 10.1080/08039488.2022.2047224. Epub 2022 Mar 4.

Abstract

Background: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are used as first-line treatment for many psychiatric diseases, especially major depressive disorder. However, an important side effect of these drugs is the risk of bleeding due to platelet dysfunction. The aim of this study was to determine the frequency of hematuria in patients using SSRI/SNRIs and to compare with a control group.

Methods: This study included patients who were followed up and treated with SSRI/SNRI in the psychiatric outpatient clinic of the Antalya Medical Park Hospital between 1 January 2021 and 31 March 2021 and a control group comprising patients who presented to the medical check-up outpatient clinic between the same dates. Complete urinalysis was performed for all patients and the results were compared between the groups.

Results: Each group included 100 patients with a female/male ratio of 1. The mean age was 41.45 ± 13.47 (16-74) years in the study group and 40.51 ± 13.75 (20-70) years in the control group (p = 0.519). Mean duration of SSRI/SNRI use in the study group was 13.35 ± 1.32 (1-64) months. The prevalence of hematuria was 17% in the SSRI/SNRI group and 6% in the control group (p = 0.015). All cases of hematuria were microscopic hematuria.

Conclusion: Hematuria is significantly more common in patients receiving SSRI/SNRI treatment. The use of SSRI/SNRI should also be taken into account when investigating the etiology of hematuria.

Keywords: SNRI; SSRI; antidepressants; hematuria; microscopic hematuria.

MeSH terms

  • Adult
  • Depressive Disorder, Major* / drug therapy
  • Female
  • Hematuria / chemically induced
  • Hematuria / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Norepinephrine / therapeutic use
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Serotonin
  • Serotonin and Noradrenaline Reuptake Inhibitors* / adverse effects

Substances

  • Selective Serotonin Reuptake Inhibitors
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Serotonin
  • Norepinephrine