Do Commonly Prescribed Antidepressants Increase The Risk Of Bleeding Stroke?

There is good news for people who take antidepressants called selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed antidepressants in the United States. A new preliminary study has found that they are not associated with an increased risk of intracerebral hemorrhage, the deadliest kind of stroke. The preliminary study released today, February 25, 2021, will be presented at the American Academy of Neurology’s 73rd Annual Meeting being held virtually April 17 to 22, 2021.

An intracerebral hemorrhage is when a blood vessel bursts in the brain sending blood into the surrounding tissue. The most common causes are high blood pressure and head trauma, but some studies have also suggested that SSRIs may increase a person’s risk of this type of bleeding stroke.

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“Selective serotonin reuptake inhibitors work by preventing reabsorption of the chemical serotonin, which regulates mood, into the cells, making more of it available in the brain,” said study author Mithilesh Siddu, MD, of the University of Miami in Florida and member of the American Academy of Neurology. “However, by interfering with serotonin, which also plays a role in blood clotting, SSRIs may increase the risk of bleeding. Therefore, to determine if these antidepressants increase the risk of bleeding strokes, we looked at a large population of people with stroke.”

For the study, researchers identified 127,915 people who had a stroke between 2010 to 2019. A total of 17,009 people had been prescribed antidepressants prior to their stroke and the other 110,906 had never had an SSRI prescription.

Researchers found that 11% of people who had been prescribed antidepressants had an intracerebral hemorrhage, compared to 14% of the people who had not. After adjusting for other factors that could affect stroke risk, such as age, high blood pressure and diabetes, researchers found that people who took antidepressants were just as likely to have an intracerebral hemorrhage as people not taking such medications.

“These findings are important, especially since depression is common after stroke and selective serotonin reuptake inhibitors are some of the first drugs considered for people,” said Siddu. “More research is needed to confirm our findings and to also examine if SSRIs prescribed after a stroke may be linked to risk of a second stroke.”

A limitation of the study was that some details regarding the length, dosage and type of antidepressants were not available to be included in the study.

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