Association Between Antidepressants Use And Intracerebral Hemorrhage: Florida Stroke Registry (5152)

2021 
Objective: NA Background: SSRIs, the most commonly prescribed antidepressants (AD) in the US, are linked to an increased intracerebral hemorrhage (ICH) risk possibly related to impaired platelet function. In the Florida Stroke Registry (FSR), we studied the proportion of cases presenting with ICH amongst AD users and the rate of SSRI prescription amongst stroke patients discharged on AD. Design/Methods: From Jan 2010 to Dec 2019 we included 127,915 cases from FSR in whom information on AD use was available. Multivariable logistic regression was used to evaluate ICH proportions amongst AD and non-AD users and rates of prescribed SSRIs at discharge. Results: The rate of ICH amongst prior AD users (n=17,009, median age 74, IQR=19) and non-AD users (n=110,906, median age 72, IQR=21) were 11% and 14% respectively. Prior AD users were more likely to be female (17% vs. 10% male), non-Hispanic White (16% vs. 8% non-Hispanic Black vs. 12% Florida Hispanic vs. 6% Puerto Rican Hispanic), have hypertension (HTN) (14.% vs. 10%), diabetes mellitus (DM) (16% vs.12%), use oral anticoagulants (OAC) (17 % vs. 13%), antiplatelets (AP; 17% vs. 11%), and statins (17% vs. 10%) prior to hospital presentation. In multivariable analysis adjusting for age, race, prior history of HTN, DM, prior OAC, AP and statin use, AD users just as likely to present with spontaneous ICH as compared to non-AD users (OR=0.92, 95% CI 0.85, 1.01). A total of 3.4% of all ICH patients and 9% of those in whom AD information was available were discharged home on an AD (74 % SSRI, 24% other AD). Conclusions: In this large population-based study, we did not find an association between prior AD use and an increased rate of ICH. Importantly AD are commonly prescribed to patients with ICH in routine clinical practice. The association between AD use in ICH patients deserves further studies. Disclosure: Dr. Siddu has nothing to disclose. Antonio Bustillo has nothing to disclose. Ozra Dehkordi has nothing to disclose. Jan Fiksa has nothing to disclose. Ms. Gardener has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intersocietal Accreditation Commission. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Pessin Katz. The institution of Ms. Gardener has received research support from Genentech. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant with A Green Slate Consulting. Dr. Koch has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Multiple Legal Matters. Dr. Koch has received stock or an ownership interest from Cerepeutics. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care. Dr. Marulanda-Londono has nothing to disclose. Chuanhui Dong has nothing to disclose. Dr. Rundek has nothing to disclose. Dr. Romano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Romano has received stock or an ownership interest from Vycor Medical/NovaVision. The institution of Dr. Romano has received research support from NIH/NINDS. The institution of Dr. Romano has received research support from Genentech, Inc. The institution of Dr. Romano has received research support from NIH/NIMHHD. Dr. Sacco has received personal compensation for serving as an employee of University of Miami. Dr. Sacco has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Sacco has received research support from NIH, NINDS, NCATS, NIMHD. The institution of Dr. Sacco has received research support from FL Department of Health. Dr. Sacco has received research support from University of Washington, Seattle. Dr. Sacco has received publishing royalties from a publication relating to health care. Dr. Asdaghi has nothing to disclose.
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