Key result
Selective serotonin reuptake inhibitor exposure was associated with an increased risk of intracranial hemorrhage (adjusted RR 1.51; 95% CI 1.26-1.81) compared to no SSRI exposure.
Why the study?
Does selective serotonin reuptake inhibitor (SSRI) exposure increase the risk of CNS hemorrhage compared to no SSRI exposure?
Meta-Analysis
Does selective serotonin reuptake inhibitor (SSRI) exposure increase the risk of CNS hemorrhage compared to no SSRI exposure?
Effect estimate: RR 1.51 (95% CI 1.26-1.81)
SSRI exposure is associated with a moderately increased relative risk of intracerebral and intracranial hemorrhage, which is further elevated when combined with oral anticoagulants, though absolute risks are likely very low.
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May warrant bleeding-risk assessment before SSRI initiation in vulnerable patients; confirms observational association and leaves open causal questions.
Hackam et al. (2012) conducted a meta-analysis in CNS hemorrhage. Selective serotonin reuptake inhibitors (SSRIs) vs. Control group not receiving SSRIs was evaluated on Intracranial hemorrhage (RR 1.51, 95% CI 1.26-1.81). Selective serotonin reuptake inhibitor exposure was associated with an increased risk of intracranial hemorrhage (adjusted RR 1.51; 95% CI 1.26-1.81) compared to no SSRI exposure.
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