Evidence map›Paper›PMID 31391245›Full record

ArticleNeurology2019

Degree of serotonin reuptake inhibition of antidepressants and ischemic risk: A cohort study.

Antonios Douros, Sophie Dell'Aniello, Golsa Dehghan, Jean-François Boivin, Christel Renoux

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Stroke risk following traumatic brain injury: Systematic review and meta-analysis.International journal of stroke : official journal of the International Stroke Society · 2021
    Pooled it
  2. Article
  3. Review
  4. Article
  5. Tryptophan: From Diet to Cardiovascular Diseases.International journal of molecular sciences · 2021
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Antonios DourosFrom the Centre for Clinical Epidemiology (A.D., S.D., G.D., J.-F.B., C.R.), Lady Davis Institute, Jewish General Hospital; Department of Epidemiology, Biostatistics, and Occupational Health (A.D., C.R., J.-F.B.) and Department of Neurology and Neurosurgery (C.R.), McGill University, Montreal, Québec, Canada; and Institute of Clinical Pharmacology and Toxicology (A.D.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.ORCID 0000-0002-6005-4006
Sophie Dell'AnielloFrom the Centre for Clinical Epidemiology (A.D., S.D., G.D., J.-F.B., C.R.), Lady Davis Institute, Jewish General Hospital; Department of Epidemiology, Biostatistics, and Occupational Health (A.D., C.R., J.-F.B.) and Department of Neurology and Neurosurgery (C.R.), McGill University, Montreal, Québec, Canada; and Institute of Clinical Pharmacology and Toxicology (A.D.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Golsa DehghanFrom the Centre for Clinical Epidemiology (A.D., S.D., G.D., J.-F.B., C.R.), Lady Davis Institute, Jewish General Hospital; Department of Epidemiology, Biostatistics, and Occupational Health (A.D., C.R., J.-F.B.) and Department of Neurology and Neurosurgery (C.R.), McGill University, Montreal, Québec, Canada; and Institute of Clinical Pharmacology and Toxicology (A.D.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Jean-François BoivinFrom the Centre for Clinical Epidemiology (A.D., S.D., G.D., J.-F.B., C.R.), Lady Davis Institute, Jewish General Hospital; Department of Epidemiology, Biostatistics, and Occupational Health (A.D., C.R., J.-F.B.) and Department of Neurology and Neurosurgery (C.R.), McGill University, Montreal, Québec, Canada; and Institute of Clinical Pharmacology and Toxicology (A.D.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Christel RenouxFrom the Centre for Clinical Epidemiology (A.D., S.D., G.D., J.-F.B., C.R.), Lady Davis Institute, Jewish General Hospital; Department of Epidemiology, Biostatistics, and Occupational Health (A.D., C.R., J.-F.B.) and Department of Neurology and Neurosurgery (C.R.), McGill University, Montreal, Québec, Canada; and Institute of Clinical Pharmacology and Toxicology (A.D.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany. christel.renoux@mcgill.ca.

Funding

CIHR MOP-133553
6 · The paper itself

Abstract

objectiveTo assess whether use of antidepressants with strong inhibition of serotonin reuptake is associated with a decreased incidence of ischemic stroke and myocardial infarction (MI).

methodsWe conducted a cohort study using the UK Clinical Practice Research Datalink and considering new users of selective serotonin reuptake inhibitors (SSRIs) or third-generation antidepressants who were ≥18 years of age between 1995 and 2014. Using a nested case-control approach, we matched each case of a first ischemic stroke or MI identified during follow-up with up to 30 controls on age, sex, calendar time, and duration of follow-up. We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) of each outcome associated with current use of strong compared with weak inhibitors of serotonin reuptake using conditional logistic regression.

resultsThe cohort included 938,388 incident users of SSRIs (n = 868,755) or third-generation antidepressants (n = 69,633). Mean age at cohort entry was 46 years (64% women). During follow-up, 15,860 cases of ischemic stroke and 8,626 cases of MI were identified and matched to 473,712 and 258,022 controls, respectively. Compared with current use of weak inhibitors of serotonin reuptake, current use of strong inhibitors was associated with a decreased rate of ischemic stroke (RR 0.88, 95% CI 0.80-0.97), but the effect size was smaller in some sensitivity analyses. The rate of MI was similar between strong and weak inhibitors (RR 1.00, 95% CI 0.87-1.15).

conclusionOur large population-based study suggests that antidepressants strongly inhibiting serotonin reuptake may be associated with a small decrease in the rate of ischemic stroke.

Indexed as

AgedAged, 80 and overAntidepressive AgentsBrain IschemiaCohort StudiesFemaleHumansMaleMiddle AgedMyocardial InfarctionRetrospective StudiesRisk FactorsSelective Serotonin Reuptake InhibitorsSerotoninStrokeAntidepressive AgentsSelective Serotonin Reuptake InhibitorsSerotonin

Identifiers

PMID31391245
PMCPMC6745737

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.