Glad to have found this forum and hopeful that your experiences can help.
A month ago my 82 year old mother experienced a minor TIA. Following many tests including blood, ct scan and MRI she was prescribed clopidogrel. Three weeks later she was in Addenbrokes for bore hole surgery to evacuate a brain bleed. The surgeon at Addenbrokes blamed the bleed on clopidogrel but stated that there is a fine balancing act between preventing stroke and preventing brain bleeds.
She has now been told that she will have to go back on clopidogrel and she is understandably frightened to death.
I don’t understand why she is being advised to go back to a drug which was the cause of her bleed.
Stroke staff have told me that when people have TIAs clopidogrel is the anti platelet drug of choice and is safe.
I’m sorry but I’m not interested in generic solutions for ‘people’. I’m interested in my mothers specific case and am not convinced that clopidogrel is the solution.
I understand that most TIAs are caused by clotting but have read that they can also be caused by minor bleeds
Any comments, help or suggestions would be very much appreciated.
@Brad Hi & welcome to the forum. Sorry that your mum has had a TIA & bleed.
Clopidogrel does seem to be the med of choice & I think most of us end up on it after an Ischaemic stroke (clot based). I thought for people who had bleeds there were different meds but I guess a lot depends on the extent of the bleed.
With all things medical there is a balance to be had between risk vs benefit. I assume they think your mums TIA was caused by a clot hence the need for clopidogrel. A TIA is a sign that a stroke could be about to happen so it’s important to get treated for it.
Perhaps you could ask the drs if there’s an alternative to clopidogrel or what the risks are if she doesn’t take it. Also whats the chances of another bleed if she does take it.
Your mum then needs to decide which option she wants to take.
Thanks for the response Ann. I’ve asked about anti coagulants instead of anti platelets but apparently they are more dangerous.
I’m new to all this and struggling to make sense of it all. I dread repeating the last month and can’t understand how the doctors expect repeating the use of clopidogrel to get different results. After all isn’t the definition of insanity to repeat the same actions and expect different results?
TIA’s are usually warning signs for full blown strokes.
Strokes are usually due to a blockage(s) in veins or arteries.
The first thing I given, immediately upon arrival at A&E was an aspirin to thin my blood (subsequently put on Clopidogrel).
As far as I’m aware, with all blood thinning drugs there’s some risk of brain bleeds.
All TIA’s are caused either by blockages or bleeds and blockages resulting in bleeds as they can burst the vessel that’s blocked.
The question is what caused the blockage? That’s the needle in the haystack that the doctors may or may never find out. Both your mum and the doctors are between a rock and a hard place. The doctors have to weigh up that risk of whether or not to give her any blood thinning medication and I don’t envy either mum or doctors. Either way there is a risk.
You’ve hit the nail on the head emerald eyes. What caused the TIA. If it was caused by a bleed (not usual but possible) is clopidogrel making the situation worse.
The terms usually and generally have no place in healthcare. Every individual is different and each case should be treated on its own merits.
I’m very late into this conversation but I’ve been researching Clopidogrel this past week for my own personal reasons and have discovered a lot of info I’m glad to have but also wish I was still in ignorance of. I’ll be discontinuing this drug on the basis that the actual (absolute) risk reduction of a further event is only 0.9%. Relative risk is the one that makes it look good and it’s 8.7% which still isn’t that great. Not when you factor in bleeding risk which rises the longer the drug is taken. And for the elderly, this is a very important consideration because the elderly tend to bleed more easily anyway.
There are many things to factor in when prescribing Clopidogrel but in reality, it’ll probably just be prescribed and hope for the best. If problems arise, it’s stopped, after it’s done its damage and the problems may have been avoided in the first place with proper evaluation.
As with everything, the information is out there. Plenty of good stuff about Clopidogrel but you need to read between the lines to find the true picture. It may help a little for those with other high risk factors but its biggest gain is for Big Pharma.