A new study has found that the combination of antidepressant drugs and nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of intracranial bleeding. The risk is present no matter what type of antidepressant drug or NSAID was used. The study was published on July 14, 2015, in the British Medical Journal.

The message to clinicians was that, when starting a patient on such a combination of drugs, special attention should be paid to monitoring for bleeding. In the retrospective study it was found that the major risk was present during the first 30 days of using the combination of drugs. Although men had a slightly stronger risk, neither old age or the use of antithrombotic agents, well know to be risk factors for intracranial hemorrhage, increased the risk factor.

Clinicians have known that taking either NSAIDs or antidepressants had a greater risk of gastrointestinal bleeding, but the risk of a brain bleed was surprising. As one doctor said, “Not that a gastric ulcer isn’t itself a concern, but with intracranial hemorrhage, that’s really a pretty serious issue. He noted that until more is understood about the relationships between the two types of drugs, the study should at least be a wakeup call for clinicians to more closely monitor drug interactions. As our society turns more and more to drugs to treat medical conditions, the risk of negative interactions becomes more of a worry.