Selective serotonin reuptake inhibitors and brain hemorrhage

  title={Selective serotonin reuptake inhibitors and brain hemorrhage},
  author={Daniel G. Hackam and Marko Mrkobrada},
  pages={1862 - 1865}
Objective: We synthesized the epidemiologic evidence concerning selective serotonin reuptake inhibitor (SSRI) exposure and the risk of CNS hemorrhage. Methods: We searched for controlled observational studies comparing SSRI therapy with a control group not receiving SSRIs. We used DerSimonian and Laird fixed effect models to compute summary risk associations. Results: Intracranial hemorrhage was related to SSRI exposure in both unadjusted (rate ratio [RR] 1.48, 95% confidence interval [CI] 1.22… Expand
Selective serotonin reuptake inhibitors and risk of cerebral bleeding.
A meta-analysis of 16 observational studies involving 506 411 participants reported that SSRIs are also associated with an increased risk of intracerebral hemorrhage, which is a leading cause of death in older people (aged >65 years). Expand
The impact of selective serotonin reuptake inhibitors on the risk of intracranial haemorrhage: A systematic review and meta-analysis
There is insufficient high-quality data to advise restriction of SSRIs because of concern regarding ICrH risk, and the association is partly accounted for by important biases and other methodological limitations in the available observational data. Expand
Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis
Risks were still higher in SSRI users than in non-users and the heterogeneities among studies were significantly decreased, but there was heterogeneity among studies and a possible confounding effect from depression could not be fully excluded, further well-designed studies are needed to confirm this association. Expand
Selective Serotonin Reuptake Inhibitors and Intracerebral Hemorrhage Risk and Outcome
In a large multiethnic cohort, pre–intracerebral hemorrhage SSRI use was not associated with increased ICH risk, but post-ICH SSri use was associated with unfavorable 3-month neurological outcome after ICH. Expand
Impact of Prestroke Selective Serotonin Reuptake Inhibitor Treatment on Stroke Severity and Mortality
Although prestroke depression in itself may increase stroke severity and mortality, this was not found in SSRI users with ischemic stroke, and SSRI use was not associated with the risk of severe stroke or death within 30 days. Expand
Association of Selective Serotonin Reuptake Inhibitors With the Risk for Spontaneous Intracranial Hemorrhage
The use of SSRIs and more generally of antidepressants with strong inhibition of serotonin reuptake are associated with an increased risk for ICH, particularly in the first 30 days of use and when used concomitantly with oral anticoagulants. Expand
Risk of Intracranial Hemorrhage Associated with the Use of Antidepressants Inhibiting Serotonin Reuptake: A Systematic Review
A systematic review of available epidemiologic evidence suggests an increased risk of ICH with antidepressants primarily inhibiting serotonin reuptake, such as SSRIs. Expand
Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta‐analysis of observational studies
This meta‐analysis shows an increased risk of bleeding of at least 36% (from 12% to 64%) based on the high‐level of observational studies with SSRIs use, which is consistent whatever the characteristics of studies. Expand
Intracerebral Hemorrhage and Outcome After Thrombolysis in Stroke Patients Using Selective Serotonin-Reuptake Inhibitors
Preadmission treatment with SSRIs was not significantly associated with an increased risk of post-thrombolysis sICH in this cohort study, however, subgroup analysis suggested an increase in risk of sich in patients taking both SSRI and OAC. Expand
SSRIs associated with increased risk of brain haemorrhage, but absolute risks low
The clinical implication of the study is that the small increase in risk of ICH should not preclude the use of SSRIs in the general population, and Hackam and colleagues suggest theUse of non-SSRI drugs in high-risk patients. Expand


Selective serotonin re-uptake inhibitors and the risk of bleeding
Analytical studies support an association between SSRI consumption and upper gastrointestinal (GI) bleeding and perioperative bleeding and little evidence links SSRI use with intracerebral haemorrhage. Expand
Risk Factors for Intracerebral Hemorrhage in the General Population: A Systematic Review
Risk factors for ICH appeared to be age, male sex, hypertension, and high alcohol intake, while high cholesterol tends to be associated with a lower risk of ICH. Expand
An analysis of psychotropic drug sales. Increasing sales of selective serotonin reuptake inhibitors are closely related to number of products.
To compare the sales of benzodiazepines and SSRIs within the primary care sector in Denmark and relate changes in usage to number of indications and products on the market, the sales curves of psychotropic drugs in the period 1970 to 2007 are established. Expand
Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis
Investigating the incidence, case fatality, and functional outcome of intracerebral haemorrhage in relation to age, sex, ethnic origin, and time period in studies published since 1980 found casefatality is lower in Japan than elsewhere, increases with age, and has not decreased over time. Expand
Paroxetine decreases platelet serotonin storage and platelet function in human beings
This work sought to characterize the potential inhibitory effect of paroxetine on platelet function and selected serotonin‐reuptake inhibitors, such as parxetine, are widely used antidepressant agents. Expand
Meta-analysis in clinical trials.
This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies. Expand
Quantifying heterogeneity in a meta-analysis.
It is concluded that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity, and one or both should be presented in publishedMeta-an analyses in preference to the test for heterogeneity. Expand
lective serotonin reuptake inhibitors and the risk of bleed
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Statistical analysis: Dr. Hackam. Study supervision or coordination: Dr. Hackam
  • Statistical analysis: Dr. Hackam. Study supervision or coordination: Dr. Hackam