Deans' stroke musings: Impact of Prestroke Selective Serotonin Reuptake Inhibitor Treatment on Stroke Severity and Mortality

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, June 5, 2014

Impact of Prestroke Selective Serotonin Reuptake Inhibitor Treatment on Stroke Severity and Mortality

This is going to be a difficult one for your doctor to analyze. Anti-depressants help your recovery.
Is your recovery more important than the risks that they may increase severity of a future stroke?
Does your doctor have any clue what I'm talking about?
http://stroke.ahajournals.org/content/early/2014/06/03/STROKEAHA.114.005302.short?rss=1

+ Author Affiliations

From the Department of Neurology, Danish Stroke Centre, (J.K.M., GA.), and Department of Clinical Epidemiology (H.L., S.P.J), Aarhus University Hospital, Aarhus, Denmark.

Correspondence to Janne Kaergaard Mortensen, MD, Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, DK 8000 Aarhus C, Denmark. E-mail janne.mortensen@ki.au.dk

Abstract

Background and Purpose—Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of bleeding but also a possible neuroprotective effect in stroke. We aimed to examine the implications of prestroke SSRI use in hemorrhagic and ischemic stroke.

Methods—We conducted a registry-based propensity score–matched follow-up study among first-ever patients with hemorrhage and ischemic stroke in Denmark (2003–2012). Multiple conditional logistic regression was used to compute adjusted odds ratios of severe stroke and death within 30 days.

Results—Among 1252 hemorrhagic strokes (626 prestroke SSRI users and 626 propensity score–matched nonusers), prestroke SSRI use was associated with an increased risk of the strokes being severe (adjusted propensity score–matched odds ratios, 1.41; confidence interval, 1.08–1.84) and an increased risk of death within 30 days (adjusted propensity score–matched odds ratios, 1.60; confidence interval, 1.17–2.18). Among 8956 patients with ischemic stroke (4478 prestroke SSRI users and 4478 propensity score–matched nonusers), prestroke SSRI use was not associated with the risk of severe stroke or death within 30 days.

Conclusions—Prestroke SSRI use is associated with increased stroke severity and mortality in patients with hemorrhagic stroke. Although prestroke depression in itself may increase stroke severity and mortality, this was not found in SSRI users with ischemic stroke.