Could Combining Antidepressants and NSAIDs Increase Hemorrhage Risk?

Combined use of antidepressants and non-steroid anti-inflammatory drugs (NSAIDs) increases the risk of intracranial hemorrhage, according to recent research.

While previous research has established an association between both NSAIDs and antidepressants with abnormal bleeding, little research exists on the risk associated when combining the 2 medications.
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In order to further examine this relationship, researchers conducted a retrospectice nationwide propensity score matched cohort study of 4,145,226 Korean patients prescribed antidepressants between January 2009 and December 2013.

Overall, researchers found that the 30 day risk of intracranial hemorrhage was higher for participants taking both antidepressants and NSAIDs (5.7 events per 1000 person-years), compared to those only taking antidepressants (1.6 events per 1000 person-years).

“ The addition of NSAIDs to antidepressant treatment increased the risk of intracranial hemorrhage within 30 days of the combination starting, especially in men,” they concluded.

“This result adds to evidence confirming the increase of risk with combination use of antidepressants and NSAIDs. Special attention is needed when patients use both these drugs together.”

—Michael Potts

Reference:

Shin J, Park M, Lee SH, et al. Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ. 2015;351:h3517.