Antidepressant use Not Linked to Serious Complications After TBI, suggests research

A new study published in the journal of Neurology showed that in individuals with traumatic brain injury (TBI), antidepressant usage is not linked to major problems.

Serotonergic antidepressant usage has been linked to poorer outcomes after TBI and an increased risk of cerebral hemorrhage. Large-scale data on their influence on TBI outcomes is still scarce, though. Thus, this study examined the relationship between pre-injury antidepressant usage, antidepressant type and serotonergic profile, and the short-term outcome of TBI, with particular attention to mortality, duration of hospital stay, and acute neurosurgery operations (ANOs).

All patients aged ≥16 who were hospitalized with TBI (ICD-10 S06.*) in Finland between 2005 and 2018 were included in this countrywide, retrospective cohort research. Using the daily pill counting approach, preinjury antidepressant usage (Anatomical Therapeutic Chemical codes N06A* and N06CA*) was discovered from national prescription data and classified by serotonergic profile (weak, moderate, and strong).

ANOs and hospital stay duration were secondary outcomes, but 30-day mortality was the main endpoint. Age, sex, comorbidities, usage of vitamin K antagonists (VKAs), admission site, and study year were all taken into account when using Cox proportional hazards models for mortality analysis, modified Poisson regression models for ANOs, and linear regression models for hospitalization.

7,845 (14.3%) of the 54,876 TBI patients were on antidepressants at the time of the injury. Antidepressant usage and 30-day mortality did not significantly correlate, according to adjusted models (adjusted hazard ratio 0.98; 95% CI 0.90–1.07; p = 0.696). Antidepressant kind or serotonergic profile did not correlate with mortality.

ANOs were less likely to occur in people using antidepressants (adjusted relative risk 0.89; 95% CI 0.82–0.97; p = 0.007). There was no difference in the length of hospital stay between groups. The relationship between VKA usage and higher mortality or ANOs in the interaction analyses was unaffected by antidepressant use, type, or profile.

Overall, regardless of antidepressant class or serotonergic profile, preinjury antidepressant usage was not linked to higher mortality, a greater requirement for ANOs, or longer hospital stays in TBI patients. These findings point to no negative effects of preinjury antidepressant usage on early clinical outcomes following traumatic brain injury.

Reference:

Posti, J. P., Tornio, A., Ruuskanen, J. O., & Kytö, V. (2026). Impact of antidepressant use and serotonergic profile on short-term outcome of traumatic brain injury: Retrospective nationwide cohort study. Neurology, 106(4), e214602. https://doi.org/10.1212/WNL.0000000000214602