BACKGROUND AND PURPOSE: Selective serotonin reuptake inhibitors (SSRI) are widely prescribed. Several reports have observed an increased bleeding risk associated with SSRI use, which is hypothesized to be secondary to their antiplatelet effect. METHODS: We tested the hypothesis that SSRIs increase the risk for or potentiate the risk of hemorrhagic stroke associated with antiplatelets and anticoagulants. RESULTS: In multivariate analysis, we found no increased risk associated with SSRI use for intracerebral hemorrhage (odds ratio=1.1, 95% CI: 0.7 to 1.8; P=0.63) or subarachnoid hemorrhage (odds ratio=0.6, 95% CI: 0.4 to 1.0; P=0.054). In addition, potentiation of risk with warfarin or antiplatelets was not observed. CONCLUSIONS: Further studies with larger populations would be needed to exclude a small increase in intracranial hemorrhage risk with SSRI use.
BACKGROUND AND PURPOSE: Selective serotonin reuptake inhibitors (SSRI) are widely prescribed. Several reports have observed an increased bleeding risk associated with SSRI use, which is hypothesized to be secondary to their antiplatelet effect. METHODS: We tested the hypothesis that SSRIs increase the risk for or potentiate the risk of hemorrhagic stroke associated with antiplatelets and anticoagulants. RESULTS: In multivariate analysis, we found no increased risk associated with SSRI use for intracerebral hemorrhage (odds ratio=1.1, 95% CI: 0.7 to 1.8; P=0.63) or subarachnoid hemorrhage (odds ratio=0.6, 95% CI: 0.4 to 1.0; P=0.054). In addition, potentiation of risk with warfarin or antiplatelets was not observed. CONCLUSIONS: Further studies with larger populations would be needed to exclude a small increase in intracranial hemorrhage risk with SSRI use.
Authors: An Pan; Olivia I Okereke; Qi Sun; Giancarlo Logroscino; JoAnn E Manson; Walter C Willett; Alberto Ascherio; Frank B Hu; Kathryn M Rexrode Journal: Stroke Date: 2011-08-11 Impact factor: 7.914
Authors: William J Meurer; Heemun Kwok; Lesli E Skolarus; Eric E Adelman; Allison M Kade; Jack Kalbfleisch; Shirley M Frederiksen; Phillip A Scott Journal: Acad Emerg Med Date: 2013-02 Impact factor: 3.451