The cerebrovascular effects of selective serotonin-reuptake inhibitors (SSRIs) are of major clinical concern, since SSRIs are known to increase the risk of bleeding through their antiplatelet effects1,2 and serotonin syndrome or serotonergic activation may cause vasoconstrictive stroke (Call-Fleming syndrome)3-5 or vasospasm.6 Two population-based control studies have failed to show any significant association between SSRI use and the risk of hemorrhagic or ischemic stroke7,8; in fact, SSRIs are the preferred antidepressants for patients who have had a stroke.9,10 However, several hundred SSRI treatment–related cerebrovascular adverse drug reactions (CV-ADRs) have been documented in the World Health Organization (WHO) drug monitoring program.11 Based on postmarketing drug surveillance data, stroke is considered an infrequent and rare adverse reaction of SSRIs (fluoxetine, paroxetine, sertraline, citalopram).12
Cece wrote:You haven't been treated for CCSVI yet, right? It's seems logical to me that the slow flow environment created by CCSVI blockages causes medicines to have a longer-than-expected amount of exposure to the brain. A leaky blood-brain-barrier might do that as well. For myself, I found I had greater tolerance of alcohol, for example, after CCSVI treatment.
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