Stroke/AHA news

International Stroke Conference: Common antidepressants appear safe for most stroke patients

February 7, 2024

SSRI/SNRIs are generally safe to start during the early stages of recovery for patients with acute ischemic stroke, according to a study presented at the American Stroke Association's International Stroke Conference in Phoenix. However, researchers found that taking SSRIs and SNRIs in combination with dual antiplatelet therapy (DAPT) increased the risk of a hemorrhagic stroke by 29% and other serious bleeding problems by 10%.

• A total of 666,150 patients were included [no antidepessants (AD) (n=607,278), SSRI/SNRI (n=35,631), other AD (n=23,241)].
• Early use of SSRI/SNRIs (vs. no ADs) was not associated with an increased risk of a major bleed for all patients (n=35,557 matched pairs) or among patients taking an anticoagulation drug, such as warfarin, apixaban, and rivaroxaban (n=7,672 matched pairs).
• However, concurrent use of SSRI/SNRIs and DAPT was associated with a 29% increased risk of hemorrhagic stroke (RR, 1.29; 95% confidence interval [CI], 1.11-1.50; n=8,381 matched pairs).
• Among patients on ADs, bleeding risks were 15% higher for use of “other ADs” (mirtazapine, bupropion, tricyclics and other antidepressants of a different class) vs. "SSRI/SNRIs" (n=21,810 matched pairs).

Sources:

American Heart Association News. (2024, February 1). American Stroke Association. Common antidepressants appear safe for most stroke survivors. https://www.stroke.org/en/news/2024/02/01/common-antidepressants-appear-safe-for-most-stroke-survivors

Simmonds KP, et al. (2024, February 1). Stroke. 2024;55:A117. International Stroke Conference 2024 Oral Abstracts Session Title: Clinical, Rehabilitation and Recovery Oral Abstracts. Abstract 117: Bleeding Risks for Acute Ischemic Stroke Patients on Serotonergic Antidepressants and Anticoagulation/Dual Anti-Platelet Therapy. https://www.ahajournals.org/doi/10.1161/str.55.suppl_1.117