A population-based cohort study in the UK revealed that the use of selective serotonin reuptake inhibitors (SSRIs) and antidepressants that are strong inhibitors of serotonin reuptake were associated with an increased risk for intracranial hemorrhage (ICH). The study included 1 363 990 users of antidepressants (36.8% male; 63.2% female; mean [SD] age, 47.9 [18.5] years) from January 1, 1995, to June 30, 2014, 3036 cases of ICH were identified during follow-up (follow-up was completed on October 31, 2014) and matched to 89 702 controls. Current SSRI use was associated with an increased risk for ICH (risk ratio [RR] 1.17) relative to tricyclic antidepressants, highest during the first 30 days of use (RR 1.44), and translating in very few additional events. The risk was even higher with strong inhibitors (RR 1.25) and highest during the first 30 days of use (RR 1.68). Concomitant use of anticoagulants may increase the risk substantially (RR 1.73). The findings suggest that caution must be exerted, especially with concomitant use of anticoagulants. Source: http://jamanetwork.com/
英国基于人口的群组研究显示，使用选择性血清素再摄取抑制剂及血清素再摄取强抑制剂的抗抑郁药与颅内出血风险增加有关。该研究包括从1995年1月1日至2014年6月30日的1363990例使用抗抑郁药者（36.8％为男性，63.2％为女性，平均【标准差】年龄为47.9 [18.5] 岁），随访发现了3036例颅内出血 （随访完成于2014年10月31日），并与89702例对照匹配。相对于三环抗抑郁药，正在用选择性血清素再摄取抑制剂者与颅内出血风险增加（风险比 1.17）相关，在使用的前30天内最高（风险比1.44），此后则非常少见。强抑制剂的风险更高（风险比 1.25），在使用的前30天内最高（风险比 1.68）。同时使用抗凝剂可使风险大大增加（风险比 1.73）。研究结果表明，必须要谨慎，特别是合用抗凝剂时。来源：http://jamanetwork.com/