Depression, SSRI Use Up Stroke Mortality

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Five-year mortality among stroke survivors was highest among patients with depression, with the association strongest among those aged younger than 65 years, according to researchers. 

Among 1,354 patients from the South London Stroke Register who survived stroke and underwent depression screening at three-month follow up, those with depression had a nearly twofold increase in mortality at five years (hazard ratio: 1.41; 95% CI: 1.13-1.77; P=0.002), Luis Ayerbe, PhD, of the Blizard Institute at Barts and The London School of Medicine and Dentistry at Queen Mary University of London in the United Kingdom, and colleagues reported in Neurology

Post-stroke mortality risk was even higher among those who initiated selective serotonin reuptake inhibitor use (HR 1.72; 95% CI: 1.34-2.20; P<0.001), regardless of depression at three months, the researchers found. The association was strongest among those aged younger than 65 years. These findings remained significant even after the researchers adjusted for comorbidities, smoking and alcohol use, social support, and medication compliance. 

The cohort study included 3,722 patients with sociodemographic and stroke severity data available, who were assessed for depression three months after stroke onset using the Hospital Anxiety and Depression Scale. Overall, 32.1% of participants had depression and 24.4% died within five years, the researchers found. 

"Depression after stroke is associated with higher mortality, particularly among younger patients," the researchers concluded. "Stroke survivors taking SSRIs have an increased mortality. The association between depression and mortality is not explained by other individual medical factors. 

 

Depression, SSRI Use Associated with Higher Stroke Mortality
Depression, SSRI Use Associated with Higher Stroke Mortality

Luis Ayerbe, PhD, of Queen Mary University of London in the United Kingdom, and colleagues assessed data from 3,722 patients included in the South London Stroke Register (1998–2013) to identify explanatory factors for the association between depression and increased mortality up to five years after stroke.

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