SSRIs After Stroke: Should They Be Used Routinely?

This meta-analysis suggests that these antidepressants improve outcomes, even in nondepressed patients.

We have reported previously on the evidence supporting antidepressants' efficacy in, for example, treating depression in patients with stroke (NEJM JW Psychiatry Jun 27 2011) and improving their recovery (NEJM JW Psychiatry Feb 22 2010). Concerns, however, have also been raised that selective serotonin reuptake inhibitors (SSRIs) might increase risk for intracerebral bleeds (NEJM JW Psychiatry Nov 5 2012). This report synopsizes a meta-analysis of 52 trials (N=4060) comparing SSRIs with control treatments, which was published as a separate Cochrane review (Cochrane Database Syst Rev 2012; 11:CD009286).

SSRI use was associated with less dependence, disability, neurological impairment, anxiety, and depression. Benefits appeared larger in patie…

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

SSRIs After Stroke: Should They Be Used Routinely?

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Reviewing Author