Excess Risk for Intracranial Hemorrhage with Concurrent Antidepressants and NSAIDs

Use of either antidepressants or nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with excess risk for upper gastrointestinal bleeding; risk is even higher when these drugs are used concurrently. Moreover, a 2012 meta-analysis showed a small excess risk for intracranial hemorrhage (ICH) in patients who received selective serotonin reuptake inhibitors (NEJM JW Psychiatry Dec 2012 and Neurology 2012; 79:1862), but whether concurrent use of antidepressants and NSAIDs poses additional risk for ICH is unknown. In this retrospective, propensity score–matched cohort study, Korean researchers compared risks for ICH in 4.1 million new users of antidepressant drugs who did or did not concurrently use NSAIDs.

After adjustment for multiple va…