The use of antidepressants and the risk of haemorrhagic stroke: a nested case control study
The use of antidepressants and the risk of haemorrhagic stroke: a nested case control study
复制标题
DOI：
10.1111/j.1365-2125.2010.03797.x
复制
发表时间：
2011-01-01
影响因子：
3.4
通讯作者：
Irvine, David
中科院分区：
文献类型：
--
作者：
Douglas, Ian;Smeeth, Liam;Irvine, David
选择性5-羟色胺再摄取抑制剂（SSRI）与出血性疾病的风险增加有关sites.center，目前尚不清楚它们是否会增加出血性中风的风险，报道的结果相互矛盾。本研究补充内容我们发现SSRI的使用与出血性中风之间没有联系stroke.center。大量的患者参与了这项研究，使我们能够排除任何实质性的effect.center。在有和没有脑血管事件病史的人中，结果相似。使用与抗抑郁药使用者队列中出血性中风风险增加相关。METHODS我们进行了一项病例对照研究，嵌套在英国全科医学研究数据库中的抗抑郁药使用者队列中。确定了1992年至2006年期间处方SSRI或三环类抗抑郁药的365195例患者的队列。观察了357例出血性卒中病例，并选择了1631例无出血性卒中的对照患者。初步分析显示，目前SSRI或TCA使用与出血性卒中之间无关联。与出血性卒中时未使用SSRI相比，目前使用SSRI的校正比值比为1.11（95%置信区间（CI）0.82，1.50）。目前使用三环类药物的等效比值比为0.73（0.52，1.02）。没有证据表明，以前的脑血管事件修改的效果SSRIs或TCAs.CONCLUSIONSWe发现没有证据表明，SSRIs与出血性中风的风险增加，无论以前的脑血管事件的历史。
center dot Selective serotonin re-uptake inhibitors (SSRI) are associated with an increased risk of bleeding disorders at a number of sites.center dot It is currently unclear whether they increase the risk of haemorrhagic stroke, with conflicting results reported.WHAT THIS STUDY ADDScenter dot We found no association between SSRI use and haemorrhagic stroke.center dot The large number of patients involved in the study allowed us to rule out any substantial effect.center dot The results were similar in people with and without a previous history of cerebrovascular events.AIMTo investigate whether selective serotonin re-uptake inhibitor (SSRI) use is associated with an increased risk of haemorrhagic stroke in a cohort of antidepressant users.METHODSWe conducted a case control study, nested within a cohort of antidepressant users in the United Kingdom General Practice Research Database. A cohort of 365 195 patients prescribed either an SSRI or tricyclic antidepressant between 1992 and 2006 was identified. Three hundred and fifty-seven cases of haemorrhagic stroke were observed and 1631 control patients without haemorrhagic stroke were selected.RESULTSThe primary analysis showed no evidence of an association between current SSRI or TCA use and haemorrhagic stroke. Current use of an SSRI compared with no use at the time of haemorrhagic stroke was associated with an adjusted odds ratio of 1.11 (95% confidence interval (CI) 0.82, 1.50). For current tricyclic use the equivalent odds ratio was 0.73 (0.52, 1.02). There was no evidence that prior cerebrovascular events modified the effect of either SSRIs or TCAs.CONCLUSIONSWe found no evidence that SSRIs are associated with an increased risk of haemorrhagic stroke, regardless of prior history of cerebrovascular events.