At Risk for Stroke?

SSRI antidepressants slightly increase risk of rare stroke for some people

(RxWiki News) Taking any medication requires patients to balance the risks and benefits of the drug. But these vary by person because every person is unique. Antidepressants, for example, affect different people in different ways.

A recent study found that people taking a certain class of anti-depressants may be at a slightly higher risk of two types of rare stroke.

The research revealed evidence that people taking antidepressants appear to be slightly more at risk for experiencing two types of brain bleeding that can lead to a stroke: an intracranial hemorrhage and an intracerebral hemorrhage.

Both of these hemorrhages are very rare, however, and the increased risk with taking antidepressants is very small.

"Ask your doctor about medication risks."

The study, led by Daniel G. Hackam, MD, PhD, of the Stroke Prevention and Atherosclerosis Research Center and the Department of Medicine at Western University in London, Canada, looked at the current research literature related to strokes and antidepressants.

Specifically, the researchers searched for all controlled observational studies involving selective serotonin reuptake inhibitors (SSRIs), a large class of antidepressants.

Commonly prescribed SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).

Overall, the researchers looked at 16 studies that involved over 500,000 participants.

For every 10,000 people taking antidepressants in a year, there would be an estimated one additional stroke.

Currently, in a group of 10,000 people, 25 would be expected to have a stroke over a ten-year period.

The risk was a little higher for people taking both SSRIs and anticoagulant medication. The authors note that people who have already had a stroke may be at higher risk.

“Overall, these results should not deter anyone from taking an SSRI when it is needed,” Dr. Hackam said in a release about the study.

“In general these drugs are safe, and obviously there are risks to having depression go untreated."

The authors suggested that doctors might consider non-SSRI treatments for patients if they have a personal history of stroke, other risk factors for a brain hemorrhage (like taking blood thinners) or patients with cerebral amyloid angiopathy or severe alcoholism.

The study was published October 17 in the journal Neurology.

The authors reported no conflicts of interest. Information regarding funding was unavailable.

Review Date: 
October 24, 2012