Comparison of the Effects of Serotonin-Norepinephrine Reuptake Inhibitors Versus Selective Serotonin Reuptake Inhibitors on Cerebrovascular Events

Lee, Yen-Chieh; Lin, Chin‐Hsien; Lin, Mong-Wei; Lu, Yun; Chang, Chia‐Hsuin; Lin, Jou‐Wei

doi:10.4088/jcp.14m09394

Cited by 16 publications

(11 citation statements)

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“…We compare our approach to a previously published study by Lee et al . [ 18 ]. Whereas that study compares new users of the entire drug classes to which these drugs belong, our analysis investigates new users of the two specific drugs.…”

Section: Resultsmentioning

confidence: 99%

“…This result stands agreement with Lee et al . [ 18 ], who included 76 920 new users of the class containing duloxetine and 582 650 new users of the class containing sertraline, and reports an adjusted hazard ratio of 1.01 (95% CI: 0.90–1.12). Both studies also include sensitivity analyses that consider an alternative time-at-risk definition and show little variation in the estimate.…”

Section: Resultsmentioning

confidence: 99%

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Improving reproducibility by using high-throughput observational studies with empirical calibration

Schuemie

Ryan

Hripcsak

et al. 2018

Phil. Trans. R. Soc. A.

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Concerns over reproducibility in science extend to research using existing healthcare data; many observational studies investigating the same topic produce conflicting results, even when using the same data. To address this problem, we propose a paradigm shift. The current paradigm centres on generating one estimate at a time using a unique study design with unknown reliability and publishing (or not) one estimate at a time. The new paradigm advocates for high-throughput observational studies using consistent and standardized methods, allowing evaluation, calibration and unbiased dissemination to generate a more reliable and complete evidence base. We demonstrate this new paradigm by comparing all depression treatments for a set of outcomes, producing 17 718 hazard ratios, each using methodology on par with current best practice. We furthermore include control hypotheses to evaluate and calibrate our evidence generation process. Results show good transitivity and consistency between databases, and agree with four out of the five findings from clinical trials. The distribution of effect size estimates reported in the literature reveals an absence of small or null effects, with a sharp cut-off at p = 0.05. No such phenomena were observed in our results, suggesting more complete and more reliable evidence.This article is part of a discussion meeting issue ‘The growing ubiquity of algorithms in society: implications, impacts and innovations’.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Improving reproducibility by using high-throughput observational studies with empirical calibration

Schuemie

Ryan

Hripcsak

et al. 2018

Phil. Trans. R. Soc. A.

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“…An analysis focused exclusively on the risk of SDH associated with antidepressant use has not previously been published. Other factors further complicate comparisons with previous results, as emphasized in a recent systematic review of 12 studies, which reported substantial heterogeneity with regard to design . However, two previous studies were noted for their large size and lack of major methodological limitations .…”

Section: Discussionmentioning

confidence: 96%

“…Selective serotonin reuptake inhibitors (SSRIs) are frequently used to treat depression and other psychiatric disorders and have been suspected of increasing the risk of bleeds through mechanisms affecting platelet function . Several studies of SSRI use as a risk factor for severe bleeds have been published, including studies of intracranial hemorrhage . However, in most studies, different intracranial bleed events have been pooled, a practice criticized by some, as it may conceal effects particular to one type of bleed .…”

Section: Introductionmentioning

confidence: 99%

Antidepressant drug use and subdural hematoma risk

Garcı́a-Dorado

Rodrı́guez

Hald

et al. 2020

Journal of Thrombosis and Haemostasis

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Background: Selective serotonin reuptake inhibitors (SSRIs) use may be associated with development of subdural hematoma (SDH). Objectives:To estimate SDH risk associated with antidepressant use, including when combined with antithrombotics, or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients/Methods:We performed this case-control study based on Danish registries.We included 10 885 incident cases of SDH and 435 379 matched general population controls. We calculated odds ratios (95% confidence interval) adjusted for comorbidity, co-medication, education level, and income (aOR). Results:We found that current use of ) and non-SSRIs ) was associated with a higher SDH risk, compared with nonuse of antidepressants. Risks were higher with short duration of current use (eg,

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“…As a secondary mechanism of action, SSRIs increase efficacy of 5-hydroxytryptamine (5-HT) neurons by desensitizing 5-HT autoreceptors of the serotonin nerve terminals. 4 , 5) …”

Section: Introductionmentioning

confidence: 99%

Codeine Precipitating Serotonin Syndrome in a Patient in Therapy with Antidepressant and Triptan

Milano

Natta

Bello

et al. 2017

Clin Psychopharmacol Neurosci

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The serotonin syndrome is a serioius medical condition due due to an intensive stimulation of setonin receptors. It is a rare, but severe, consequence of interaction between serotomimetic agents. This is a report of a 70-year-old woman steadily in therapy with venlafaxine and rizatriptan for migraine and major depressive syndrome. She was admitted to neurology unit for decreased light reflex with miotic pupils, global hyperreflexia, tremor, anxiety, ataxia and incoordination. The patient was diagnosed as a probable case of serotonin syndrome due to a pharmacological interaction between venlafaxine and rizatriptan trigged by opioid intake. In this paper, the development of syntomatology, the clinical examination and the possible pharmacokinetics explanation were carefully discussed and analysed.

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Comparison of the Effects of Serotonin-Norepinephrine Reuptake Inhibitors Versus Selective Serotonin Reuptake Inhibitors on Cerebrovascular Events

Abstract: Use of SNRIs is not associated with an increased risk of either ischemic stroke or intracranial hemorrhage as compared to use of SSRIs in adult patients with depression or anxiety. However, SNRIs should be used cautiously in patients without depression.

Cited by 16 publications

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Improving reproducibility by using high-throughput observational studies with empirical calibration

Improving reproducibility by using high-throughput observational studies with empirical calibration

Antidepressant drug use and subdural hematoma risk

Codeine Precipitating Serotonin Syndrome in a Patient in Therapy with Antidepressant and Triptan

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