Risk of stroke among older Medicare antidepressant users with traumatic brain injury

Be careful out there.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J75311&phrase=no&rec=132740&article_source=Rehab&international=0&international_language=&international_location=
Journal of Head Trauma Rehabilitation , Volume 32(1) , Pgs. E42-E49.

NARIC Accession Number: J75311.  What's this?
ISSN: 0885-9701.
Author(s): Khokhar, Bilal; Simoni-Wastila, Linda; Albrecht, Jennifer S..
Publication Year: 2017.
Number of Pages: 8.
Abstract: Study estimated the risk of stroke among older Medicare beneficiaries with traumatic brain injury (TBI) who use antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs). It was hypothesized that new use of SSRIs would be associated with an increased risk of stroke following TBI among older adults. A secondary objective was to assess the risk of stroke associated with the use of other antidepressants. Data were collected from a total of 64,214 Medicare beneficiaries aged 65 years or older who were hospitalized with a TBI during 2006 to 2010. Primary exposure was new antidepressant use following TBI identified through Medicare part D claims. The primary outcome was stroke following TBI. Ischemic and hemorrhagic strokes were secondary outcomes. Generalized estimating equations were used to estimate the relative risks of stroke. Results indicated that 20,859 (32 percent) Medicare beneficiaries used an antidepressant (exposed) at least once following TBI. SSRIs accounted for the majority of antidepressant use. SSRI use was associated with an increased risk of hemorrhagic stroke but not ischemic stroke. Specifically, the SSRIs escitalopram and sertraline were associated with an increase in the risk of hemorrhagic stroke. Serotonin norepinephrine reuptake inhibitors and phenylpiperazine antidepressants were associated with increased risk of ischemic stroke. The findings from this study will aid prescribers in choosing appropriate antidepressants to treat depression in older adults with TBI.
Descriptor Terms: BRAIN INJURIES, DEPRESSION, DRUGS, MEDICARE, OLDER ADULTS, PHARMACOLOGY, STROKE.


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Citation: Khokhar, Bilal, Simoni-Wastila, Linda, Albrecht, Jennifer S.. (2017). Risk of stroke among older Medicare antidepressant users with traumatic brain injury.  Journal of Head Trauma Rehabilitation , 32(1), Pgs. E42-E49. Retrieved 3/10/2017, from REHABDATA database.