Risk for a Brain Bleed in Antidepressant Users


Antidepressants are a very commonly prescribed drug; approximately 1 in 10 Americans use it and in women aged 40-50 the rate is 1 in 4.  The number of people on antidepressants has skyrocketed over the past 10 years due to a number of factors. While there are health risks in taking antidepressants this new study might further indicate this is a risky drug to take. This recent study published in the British Medical Journal throws up a huge red flag because it found a new risk for a brain bleed in antidepressant users.

The actual term in the study is an intracranial hemorrhage which is bleeding within in the skull and around the brain, not  within the middle of the brain as in a cerebral or intracerebral hemorrhage. Bleeding in this area can increase pressure on the brain which can crush delicate brain tissue or limit its blood supply. If not treated promptly or properly this increased pressure can cause severe and permanent brain damage. This bleeding is typically caused by the rupture of a blood vessel in the intracranial space, the rupture usually occurs due to trauma but can also be caused by a ruptured aneurysm, anticoagulant therapy, and disorders with blood clotting.

This recent paper identifies a new risk, combining antidepressant use with non-steroidal anti-inflammatory drugs (NSAID). NSAID’s are one of the most commonly used drugs to treat the inflammation that contributes to pain. It is not hard to see that the 1 in 10 Americans on an antidepressant might also take an NSAID like Advil for pain since it is estimated that more than 17million Americans use NSAID’s to manage pain. This is a large study looking at over 4 million Koreans prescribed at least on antidepressant drug from January 1 2009 to December 31 2013. The authors found combined use of antidepressants and NSAIDs was associated with an increased risk of intracranial hemorrhage within 30 days of initial combination. By themselves each drug already pose a risk for increased bleeding but when combined that risk is significantly increased according this study.

Since antidepressants are such a widely used medication it is very likely you or someone you know is taking them so then, what should you do based on the findings of this study? People taking theses medications should really discuss or discover what their real benefits of taking these medications are. From what I have read, many people taking antidepressants are doing so without meeting the diagnosis of a major depressive disorder. That does not mean the drug might not be necessary but perhaps other lifestyle changes could be made instead of taking it. As far as NSAID’s are concerned there are better ways to manage pain than taking that daily. For spine related pain, what we do is very effective and far safer than taking a daily NSAID. Even for other joint pain we have treatment methods through the BStrong4Life program that is beneficial in stabilizing the joint and reducing pain.

What it comes down to is if you are taking both of these drugs you really should only take the one that is more important for your health and well being. Taking both together is far riskier for your long term health, according to this study. This requires some serious thought and discussion to evaluate your risks and benefits with your physician and your family and friends. This probably means discussing alternative treatment options that are outside of the world of pharmacology.  Living your life taking medications indefinitely is not a solid long term strategy to manage your health. Since life expectancies are far longer today than 100 years ago taking care of your body through exercise, nutrition, and lifestyle changes to improve your long term health and wellness is going to be your best strategy.

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Posted in Healthcare Policy and Politics, Wellness

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