title: Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study.
abstract: OBJECTIVE
  To define the risk of intracranial haemorrhage among patients treated with antidepressants and non-steroid anti-inflammatory drugs (NSAIDs), compared with the risk among those treated with antidepressants without NSAIDs.
  
  
  METHODS
  Retrospective nationwide propensity score matched cohort study.
  
  
  METHODS
  Korean nationwide health insurance database between 1 January 2009 and 31 December 2013.
  
  
  METHODS
  Patients who began receiving antidepressants for the first time (index date) without a history of having received a prescription for antidepressants during the preceding year. Patients who had been diagnosed as having cerebrovascular diseases within a year before the index date were excluded.
  
  
  METHODS
  Time to first hospital admission with intracranial haemorrhage within 30 days after drug use. Matched Cox regression models were used to compare the risk of intracranial haemorrhage among patients who were treated with antidepressants with and without NSAIDs, after propensity score matching with a 1:1 ratio.
  
  
  RESULTS
  After propensity score estimation and matching in a 1:1 ratio, the cohort used in the analysis included 4,145,226 people. The 30 day risk of intracranial haemorrhage during the entire study period was higher for combined use of antidepressants and NSAIDs than for use of antidepressants without NSAIDs (hazard ratio 1.6, 95% confidence interval 1.32 to 1.85). No statistically meaningful differences were found in risk of intracranial haemorrhage between the antidepressant drug classes.
  
  
  CONCLUSIONS
  Combined use of antidepressants and NSAIDs was associated with an increased risk of intracranial haemorrhage within 30 days of initial combination.
authors.affiliation: Korea Institute of Drug Safety and Risk Management, 110-750 Seoul, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Korea Institute of Drug Safety and Risk Management, 110-750 Seoul, Korea bjpark@snu.ac.kr.
authors.forename: Mi-Ju
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Korea Institute of Drug Safety and Risk Management, 110-750 Seoul, Korea.
authors.forename: Shin Haeng
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Korea Institute of Drug Safety and Risk Management, 110-750 Seoul, Korea.
authors.forename: So-Hyun
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Korea Institute of Drug Safety and Risk Management, 110-750 Seoul, Korea.
authors.forename: Mi-Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Medical Research Collaborating Center, Seoul National University College of Medicine and Seoul National University Hospital, 110-799 Seoul, Korea.
authors.forename: Nam-Kyong
authors.initials: NK
authors.lastname: Choi
authors.affiliation: Medical Research Collaborating Center, Seoul National University College of Medicine and Seoul National University Hospital, 110-799 Seoul, Korea.
authors.forename: Joongyub
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, 110-799 Seoul, Korea bjpark@snu.ac.kr.
authors.forename: Byung-Joo
authors.initials: BJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D056911:Democratic People's Republic of Korea; D003863:Depression / Q000188:drug therapy*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors