Antidepressants not associated with serious complications from TBI: Study

Taking certain antidepressants at the time of a traumatic brain injury (TBI) is not associated with an increased risk of death, brain surgery or longer hospital stays, according to a study published on January 28, 2026, in Neurology®, the medical journal of the American Academy of Neurology.

For the study, researchers looked at serotonergic antidepressants, which treat anxiety and depression by increasing serotonin activity in the brain. These included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs).

“Concerns have previously been raised that serotonergic antidepressants might increase the risk of bleeding in the brain or complicate early recovery after traumatic brain injury,” said study author Jussi P. Posti, MD, PhD, of the University of Turku in Finland. “However, our study found no evidence to support those concerns.”

The study included 54,876 people in Finland who were 16 or older when hospitalized with a TBI. A total of 14% used serotonergic antidepressants at the time of the TBI.

Researchers reviewed national prescription records for preinjury antidepressant use and medical records to determine how many people died within a month, whether they needed emergency brain surgery, and how long they stayed in the hospital.

A total of 4,105 people died within a month. This included 7.6% of those taking antidepressants and 7.5% of people who did not.

After adjusting for factors such as age, sex and other health conditions, researchers found people taking antidepressants before injury were no more likely to die within a month than those not taking them.

Antidepressant users were slightly less likely to require emergency brain surgery to relieve pressure or bleeding in the brain and prevent further damage.

Of the total participants, 6.8% of the antidepressant users and 8.6% of those who did not use antidepressants needed emergency brain surgery. After adjustments, antidepressant users had an 11% lower risk.

The amount of time in the hospital was the same for both groups.

“These findings provide reassurance for people who take antidepressants that antidepressant use does not appear to worsen early recovery after traumatic brain injury,” said Posti. “Future studies should examine whether these results hold true for long-term recovery and across different health care settings.”

A limitation of the study was that it was conducted only at hospitals and health care centers in Finland, so results may vary in other areas.

Reference:

Jussi P. Posti, Impact of Antidepressant Use and Serotonergic Profile on Short-Term Outcome of Traumatic Brain Injury Retrospective Nationwide Cohort Study, Neurology, https://doi.org/10.1212/WNL.0000000000214602