Antidepressants linked to stroke risk

Postmenopausal women who use antidepressants are at increased risk of stroke and death than non-users, but are not more likely to have coronary heart disease (CHD), a study finds. The study of more than 136,000 Women's Health Initiative participants who were not using antidepressants at baseline found that those who started using antidepressants during follow-up were 45% more likely to have a stroke and were at a 32% greater risk of all-cause mortality. In line with other major studies, women were not more likely to have CHD and there were no significant differences in risks for stroke, CHD or mortality among women who used selective serotonin reuptake inhibitors (SSRI) or tricyclic antidepressants (TCA). In analyses by stroke type, SSRI use was associated with incident haemorrhagic stroke (HR 2.2) and fatal stroke (HR 2.10), although absolute event risks were low. “This finding suggests that neither class of antidepressant was associated with greater risk for any events,” the study authors wrote in the Archives of Internal Medicine. “However, it also raises the possibility that residual confounding by depression could account for part of the risk.” They also noted that causes of death did not indicate any category that accounted for excess risk. “Thus, it remains unclear from our data whether antidepressants have a causal effect on mortality or are merely a marker of increased risk from other causes that may not have been fully controlled,” the authors said. “Although these results raise concerns about adverse affects of antidepressants, it is important to note that depression itself has been implicated as a risk factor for CHD, stroke, early death, and other adverse outcomes,” the study authors said. “Further research is needed to clarify the risk-benefit ratio of antidepressant use among older women,” they concluded....