No association was found between the use of antidepressants (AD) and the occurrence of intracerebral hemorrhage (ICH) in a large population-based study of the Florida Stroke Registry (FSR), a voluntary stroke registry of Florida hospitals. This was the conclusion of the authors after analyzing 127,915 AD-using and non-AD-using stroke cases [1].
The use of SSRIs, a commonly prescribed AD, has been associated with an increased risk of ICH [2]. The authors hypothesized that SSRIs may increase the risk of ICH through the effect they have on serotonin, as this neurotransmitter has an influence on blood coagulation. The study compared the proportion of ICH in preliminary AD-using (n=17,009, median age 74) and non-AD-using (n=110,906, median age 72) stroke patients. No significant difference was found between the AD group (11% ICH) and the non-AD group (14% ICH). Adjusting for age, race, hypertension, diabetes mellitus, the use of anticoagulants, antiplatelets, and statins in multivariable analysis did not change this conclusion. Since AD are often prescribed to patients with ICH at hospital discharge, the authors also analyzed the rate of SSRIs among the prescribed AD. Of the ICH patients with available AD information, 9% was discharged with a prescription for AD, 74% of those were SSRIs. The study participants were exclusively stroke patients and the available information on preliminary AD use was limited. The duration, dosage and type of AD the patients had been using was not registered. The authors therefore stress the importance of further research into the association between AD and ICH.
- Siddu M, et al. Association Between Antidepressants Use And Intracerebral Hemorrhage: Florida Stroke Registry. P15.001, AAN 2021 Virtual Congress, 17-22 April.
- Javors MA, et al. Int J Neuropsychopharmacol. 2000 Sep;3(3):229-235.
