Belay ES, et al. - Researchers questioned and investigated separately 4,485 total hip arthroplasty (THA) and 5,584 total knee arthroplasty (TKA) cases from January 2013 to December 2017 at the investigating institution in order to quantify if treatment with selective serotonin reuptake inhibitors (SSRI’s) impact blood loss and transfusion rates after THA or TKA. For SSRI users, the transfusion rate was 3.9% and 8.5% in the TKA group and the THA group, respectively. SSRI utilization had a significant correlation with elevated blood loss and after controlling for age, gender, BMI, presence of coagulopathy, procedure and SSRI status; logistic regression controlling for the same variables showed SSRI utilization predicted transfusion. Particularly with THA, SSRI utilization correlated with increased perioperative blood loss and predictive of transfusion risk. Furthermore, possible alternative medications for depression in the perioperative phase are needed, but this is an important factor that could be altered in the setting of total joint arthroplasty.