SSRI are not associated with an increased risk of intracerebral hemorrhage

Contrary to previous findings, selective serotonin reuptake inhibitors (SSRI) are not associated with an increased risk of intracerebral hemorrhage (ICH), results of a large observational study show.

The findings will be presented at the American Academy of Neurology (AAN) 2021 Annual Meeting in April.

SSRIs, the most widely prescribed antidepressant in the US, have previously been linked to an increased risk of ICH, possibly as a result of impaired platelet function.

To investigate further, the researchers analyzed data from the Florida Stroke Registry (FSR). They identified 127,915 patients who suffered ICH from January 2010 to December 2019 and for whom information on antidepressant use was available.

They analyzed the proportion of cases presenting with ICH among antidepressant users and the rate of SSRI prescription among stroke patients discharged on antidepressant therapy.

The researchers found that 11% of those who had been prescribed antidepressants had an ICH, compared with 14% of those who had not.

In multivariable analyses adjusting for age, race, prior history of hypertension, diabetes and prior oral anticoagulant, antiplatelet and statin use, antidepressant users were just as likely to present with spontaneous ICH as non-antidepressant users (odds ratio [OR] 0.92; 95% CI, 0.85 - 1.01).

The authors note a key limitation of the study: some details regarding the length, dosage, and type of antidepressants were not available.