JAMA Neurol: Effects of selective 5-serotonin reuptake inhibitors on stroke recurrence and depressive symptoms in stroke-surviving patients.

Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat post-stroke depression, but studies have found that SSRIs can lead to an increased risk of cerebral hemorrhage (ICH) in the general population.
researchers recently looked at the effects of SSRI on ICH recurrence and depression in primary ICH survivors.
from January 2006 to December 2017, the researchers conducted this longitudinal study at multiple level III medical centers, with an average follow-up time of 53.2 months, including 1,279 primary ICH survivors (1,049 whites, 89 blacks, 77 Hispanics, and 64 other races/ethnicities).
researchers conducted single- and multivariate analyses of ICH recurrence risk and severity of depression, including a subset analysis of one or more factors associated with a high ICH recurrence risk: (1) large leaf ICH;
age of participants was 71.3 years, of which 602 were women (47 per cent).
treatment of ICH survivors with SSRI was associated with an increased risk of ICH recurrence (HR=1.31), but post-ICH depressive symptoms (OR=1.53) were also alleviated.
In high-risk populations with ICH recurrence (HR=1.79), the risk of recurrence of cerebral hemorrhage from taking SSRIs increased further compared to all other ICH survivors (1.20), there was no significant difference in improving depressive symptoms.
treatment with selective 5-serotonin reuptake inhibitors after primary cerebral hemorrhage may relieve depressive symptoms in patients, but increase the risk of recurrence of hemorrhagic stroke.
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