A new study has found that AF patients taking the anticoagulant medication Warfarin who are also taking SSRI antidepressant medications like Paxil may be at a higher risk of bleeding.

Selective serotonin reuptake inhibitors (SSRIs) such as Celexa, Paxil and Prozac are used to treat depression but can be very dangerous on their own. The pills have been linked to patients suffering from suicidal and violent thoughts and behavior as well as birth defects (PPHN, spina bifida, neural tube defects, oral clefts) to babies whose mothers take the drugs while pregnant. When you combine Paxil with Warfarin, you add increased bleeding risks, too. Warfarin is an anticoagulant medication that is used to help prevent strokes in patients that are suffering from atrial fibrillation, which is an irregular heartbeat and flutters.

“The most important thing would be to talk to their doctor, and perhaps for patients who are on both of these medicines, doctors should just keep a close eye on them,” said study author Gene Quinn, who was a resident physician in internal medicine at the University of California-San Francisco at the time of the study.

The results of this study were presented at the American Heart Association annual meeting in Los Angeles. For this study, the researchers analyzed data collected from more than 13,000 people who had AF and depression that were participating in another ongoing study. They found that nearly 9,200 of those patients were also taking Warfarin, and it was those people who were the focus of this new study. What the researchers learned was that the Warfarin users were divided into three groups: “Patients who were taking no antidepressants, patients who were taking SSRIs and patients who were taking [older] tricyclic antidepressants.”

When the researchers compared the bleeding risks, they found that these patients had a 60 percent higher chance of suffering from a major bleeding event than the patients that weren’t taking SSRIs and Warfarin together.