20 Aug 2023 • Swiss researchers have cautioned against the combination of lecanemab (Leqembi) and certain antidepressants due to an increased risk of intracerebral hemorrhage, particularly within the first 30 days of introducing selective serotonin reuptake inhibitors (SSRIs). Monoclonal antibodies like lecanemab, which target aggregated beta amyloid, can lead to amyloid-related imaging abnormalities (ARIA), including edema or effusion (ARIA-E) and ARIA with hemosiderin deposition (ARIA-H), which includes microhemorrhage. Patients with cerebral amyloid angiopathy (CAA) are at greater risk of ARIA, and lecanemab can be given to patients with limited microhemorrhages that could correspond to possible or probable CAA. Given this, the researchers advise close monitoring and caution when prescribing lecanemab alongside SSRIs, as antidepressant use is associated with an increased risk of developing microbleeds. The study identified 47 eligible patients, 32% of whom were on antidepressants, primarily SSRIs. The high prevalence of eligible Alzheimer's patients on antidepressants prompts questions about proper clinical management. Source: Alzheimer's & Dementia | Read full story