Risk of traumatic brain injury in older people who use individual antidepressants.

What is it about?

In this large cohort of unselected elderly new users of antidepressants (ADs), the risk of traumatic brain injury (TBI) was increased in current users of most ADs compared to persons who used any AD in the past. Taking into account a wide range of comorbidities, use of comedications and other potential confounding factors, we observed differences between individual ADs. The increase in risk was higher in current users of duloxetine (>80%), fluoxetine, sertraline, citalopram and escitalopram (>60%), while it was lower in current users of paroxetine (57%), amitriptyline (45%), trimipramine (17%) and opipramol (11%). These results were consistent in subjects with and without depression or dementia, in men and women and across all age groups.

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Why is it important?

While all examined individual selective Serotonin reuptake Inhibitors (SSRIs) had a higher risk than the individual tricyclics (TCAs), the large variability between individual ADs shows the importance of considering the safety of individual agents rather than focusing on class alone.