SSRIs, Stroke, and Mortality: Should We Be Concerned?

Mortality might increase in poststroke patients taking selective serotonin reuptake inhibitors, but the analysis of these data raises many questions.

Risk for stroke can increase with depression (NEJM JW Psychiatry Nov 7 2011), and outcomes and memory after stroke can improve with selective serotonin reuptake inhibitors (SSRIs) even in nondepressed patients (NEJM JW Psychiatry Oct 2 2013 and Feb 22 2010). However, SSRIs may increase risk for intracerebral bleeding (NEJM JW Psychiatry Nov 5 2012). To learn more about the risks and benefits of using SSRIs in stroke patients, researchers used data from a stroke registry started in 1998. They identified 1354 patients with stroke and follow-up data on depression at 3 months and mortality at 5 years; only 11% were taking antidepressants.

Depression was common (32%). At 5 years, 331 patients (24%) had died. The study involved five separate analy…

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, Stroke, and Mortality: Should We Be Concerned?

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Reviewing Author