Antidepressant/NSAID Combo Linked to Brain Bleed Risk

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Antidepressant/NSAID Combo Linked to Brain Bleed Risk

The combination of antidepressants and nonsteroidal anti-inflammatory drugs (NSAIDS) is linked to an early increased risk for intracranial hemorrhage, regardless of the type of NSAID or antidepressant, new research shows.


“The take-home message for clinicians is that special attention should be paid [to] antidepressant users when they start an NSAID prescription,” coauthor Byung-Joo Park, MD, MPH, PhD, told Medscape Medical News.


“Monitoring bleeding risk is particularly needed at the initial combined use of both medicines,” added Dr Park, who is a professor in the Seoul National University College of Medicine’s Department of Preventive Medicine, in Korea.


There were no significant differences in the increased intracranial hemorrhage risk between the antidepressant classes of serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors, or tricyclic antidepressants.


Male sex was the strongest risk factor for a higher HR for intracranial hemorrhage with the combined use of the drugs (HR, 2.6 vs 1.2 in women; P < .001).


“I think [the study] raises the very good issue that if you’re giving patients antidepressants in primary or psychiatric care, you should ask if they’re also taking aspirin or other NSAIDs, and if so, you might want to go over the risks and potentially make sure they don’t have other risk factors.”


The study was published online BMJ. Published online July 14, 2015.



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