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

1. Janne Kaergaard Mortensen, MD,
2. Heidi Larsson, MSc,
3. Søren Paaske Johnsen, MD, PhD and
4. Grethe Andersen, MD, DMSc

+ Author Affiliations

1. 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.

1. 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.