In a new Canadian study published in the journal Nephrology, it is reported that although small, there is an increased risk of brain hemorrhage associated with use of selective serotonin reuptake inhibitors (SSRIs), after looking at the findings from 16 studies involving more than 500,000 people. (Not all participants were SSRI users).
SSRIs are the most common drugs prescribed for patients with depressive symptoms. There were 254 million prescriptions written in the U.S. in 2010. These drugs are effective in alleviating the symptoms of depression in moderate to severe cases. SSRIs are sometimes prescribed to treat conditions other than depression, as well. The most widely prescribed antidepressants are fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil), escitalopram (Lexapro) and fluoxetine combined with olanzapine (Symbax).
Overall, antidepressant users were about 40-50 percent more likely to suffer bleeding in or around the brain. Although this seems high, the risks to any one person would be “extremely low,” said lead researcher Daniel Hackam, an associate professor of medicine at Western University in London, Ontario, Canada.
Based on these figures, he said, there would be one brain hemorrhage for every 10,000 people using an SSRI over one year.
The SSRIs have been linked to a risk of stomach bleeding, but studies have been conflicting whether SSRI users have a higher risk of hemorrhagic stroke, which occurs when there is bleeding present in or around the brain.
It was observed that hemorrhagic risk seemed greatest in the first months after people started using an SSRI. In addition, SSRIs seem to make it harder for blood (platelets) to clump together forming clots, as there can be a decrease in platelet functions during the first few weeks after starting the SSRI, he said.
Dr. Hackam stressed that people on antidepressants should not be alarmed and thinks, “overall, these medications are quite safe.” The people who are already at increased risk of brain hemorrhage need to be careful. This includes people who had had a prior brain bleed or those on medications that reduce blood clotting.
SSRIs work by altering neurotransmitter levels in the brain. Neurotransmitters are chemical messengers that are used for communications between brain cells. The SSRIs inhibit (block) the reuptake (reabsorption) of serotonin, a neurotransmitter, producing higher levels of serotonin, which improves mood. SSRIs work only on serotonin, which is why they are called “selective.”
Although there are side effects to many medications, you must weigh the risks with the benefits. It is great that antidepressants can help improve moods in patients suffering from depressive conditions, but a bleeding brain can really give you something to be depressed about. If there is a danger involving a medication, the public is entitled to know about it.
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