Moderate
Established
描述
Combining aspirin with escitalopram increases the risk of GI bleeding through additive impairment of hemostasis.
机制
Escitalopram depletes platelet serotonin via SERT blockade, reducing aggregation; aspirin inhibits COX-1–mediated thromboxane A2. Together they impair hemostasis through complementary mechanisms.
临床意义
Population studies show a 2- to 3-fold increase in upper GI hemorrhage with combined SSRI + aspirin vs. aspirin alone.
处理措施
Co-prescribe a PPI when combining antidepressants with antiplatelet aspirin; counsel patients on GI bleeding warning signs.