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Antidepressants are associated with hospital admitted intracranial bleeds in people taking other medication associated with bleeding
  1. Richard Morriss
  1. Correspondence to Division of Psychiatry—University of Nottingham, UK; richard.morriss{at}

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ABSTRACT FROM: Shin JY, Park MJ, 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.

What is already known on this topic

Antidepressants might decrease platelet aggregation, while non-steroidal anti-inflammatory drugs (NSAIDs) may also inhibit platelet function, so both may increase bleeding.1 While antidepressants and NSAIDS are thought to increase gastrointestinal haemorrhage,1 there are contradictory results on the risk of intracranial haemorrhage (ICH) with the coprescription of antidepressants and NSAIDs in case control and population studies.2 ,3 Antidepressants alone are not thought to increase the risk of intracranial haemorrhage.4

Methods of the study

A nationwide cohort study of all healthcare insurance claims covering all the population of Korea was carried out. The study examined healthcare claims for people with depression started on antidepressants (including monoamine oxidase inhibitors, buproprion, hypericin, tianeptin) over a 4-year period (2009–2013). NSAIDs included selective inhibitors of COX-2 but …

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  • Competing interests RM is currently funded on studies for depression by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM) and the Mind Tech Health Technology Co-operative.

  • Provenance and peer review Commissioned; internally peer reviewed.