Antidepressant use with high (OR 0.82; 95% CI 0.44-1.55), medium, or low serotonin reuptake inhibition was not significantly associated with hemorrhagic stroke risk compared to non-use.
Case-Control (n=644)
Does the degree of serotonin reuptake inhibition in antidepressants affect the risk of hemorrhagic stroke in patients with depression?
The risk of hemorrhagic stroke in depressed patients does not appear to be related to the degree of serotonin reuptake inhibition of the antidepressants used.
Odds Ratio: 0.82 (95% CI 0.44–1.55)
OBJECTIVE: This study aimed to determine whether the degree of serotonin (5-HT) reuptake inhibition affects risk of hemorrhagic stroke associated with antidepressant use in patients with depression. METHOD: A population-based, nested case-control study was performed using a managed care medical claims database. Ninety two depressed patients with a diagnosis of hemorrhagic stroke were identified and matched with 552 controls by age, sex, and year of index date of depression (IDD). Diagnoses of depression, hemorrhagic stroke, and other medical comorbidities were identified using ICD-9 codes. Antidepressants were classified as high, medium, or low reuptake inhibition based on their affinities for the 5-HT reuptake transporter, determined using their respective equilibrium dissociation constants (K(D); high: K(D) or= 10 nM). Conditional logistic regression analysis was performed to estimate the crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of the risk of hemorrhagic stroke. RESULTS: Compared to non-users of antidepressants, risk of hemorrhagic stroke did not significantly differ between patients who had ever used antidepressants with high (OR = 0.82; 95% CI = 0.44-1.55), medium (OR = 0.93; 95% CI = 0.37-2.31), or low (OR = 0.38; 95% CI = 0.11-1.41) 5-HTT inhibition. CONCLUSION: Risk of hemorrhagic stroke associated with antidepressant use may not be related to an antidepressant's degree of 5-HT reuptake inhibition. Given the limitations of this study, additional studies are needed to confirm these findings.
Chen et al. (2008) conducted a case-control in Depression (n=644). Antidepressants (high, medium, or low serotonin reuptake inhibition) vs. Non-users of antidepressants was evaluated on Hemorrhagic stroke (OR 0.82, 95% CI 0.44-1.55). Antidepressant use with high (OR 0.82; 95% CI 0.44-1.55), medium, or low serotonin reuptake inhibition was not significantly associated with hemorrhagic stroke risk compared to non-use.