In a related editorial, the authors discuss the implications of these findings, highlighting that one of the shortcomings of present in this study derives from the “lumping of multiple different diseases under the rubric of intracranial haemorrhage. Primary non-traumatic intracerebral haemorrhage, spontaneous subdural haematoma, and subarachnoid haemorrhage are separate conditions with separate causes. Platelet dysfunction and resultant coagulopathy might be a common risk for intracerebral haemorrhage and extra-axial cerebral bleeding. However, the role of antiplatelet agents in the occurrence of aneurysmal subarachnoid haemorrhage is controversial, with some suggesting aspirin as protective and others suggesting an increased subarachnoid haemorrhage risk”.
The authors conclude that this study helps bolster the biological plausibility regarding SSRIs and haemorrhage risk, and ideally, clinicians should use this information to add to the litany of potential risks when counselling patients regarding starting SSRI therapy and assessing whether the benefits for depression or other indications outweigh these risks.