Risk for ICH is statistically significant, but usually will not affect clinical decisions.
Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with excess risk for bleeding, presumably due to the antiplatelet effect of these antidepressants. In a population-based retrospective cohort study of some 1,360,000 new users of antidepressants over a 20-year period (1995–2014) in the U.K., researchers evaluated risk for spontaneous intracranial hemorrhage (ICH) in SSRI users compared with tricyclic antidepressant (TCA) users. In all, 3036 ICH cases were matched with 89,702 controls (overall mean age, 66.6; 39.6% men).
Overall incidence of spontaneous ICH was 3.8 per 100,000 persons per year. Common risk factors (e.g., alcohol abuse, hypertension, use of anticoagulants or antiplatelet agents such as aspirin) were mor…
Reviewing Author
DisclosuresRoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions
Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience
Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)
DisclosuresRoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions
Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience
Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)