Taking paroxetine with aspirin or ibuprofen. There is a possible increase risk of bleeding if this would be used together on a long-term basis. The release of serotonin by our blood platelets is important in maintaining hemostasis. Any of the SSRI agents used with aspirin or drugs like ibuprofen Aleve or Advil may increase your risk for bleeding. In 2003, a study was actually done because there are GI side effects reported with the use of SSRIs and the findings from this study reported that the use of an SSRI carries an increased risk for GI bleed and that combined use of an SSRI with an NSAID like ibuprofen Aleve, Naproxen, or an aspirin product carried an even higher risk for GI bleed. Hospitalizations for upper GI bleeding were looked at among 26, 000 users of anti-depressants and it was compared those with the number of upper GI bleeds that were in patients that did not take anti-depressants. For the patients on anti-depressants, the amount of GI bleeding episodes was 3.6 times more than expected. They found the use of SSRIs plus low-dose aspirin increased the risk by 5.2 times and the use of an SSRI plus an NSAID like ibuprofen, Advil or Aleve increased the risk by 12.2 times. And because of this, it is important for patients to be aware of the possibility of GI side effects and confer with your physician if they occur. In practice, it is now more common to see some patients like the elderly being maintained on SSRI medications for depression being also placed on one of the proton pump inhibitor agents and these would be something like Prevacid, Omeprazole or Prilosec or Protonix.