ArticleStroke and vascular neurology2021
Patterns of antidepressant therapy and clinical outcomes among ischaemic stroke survivors.
Article in Stroke and vascular neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Effects of Immersive Virtual Therapy as a Method Supporting Recovery of Depressive Symptoms in Post-Stroke Rehabilitation: Randomized Controlled Trial.Clinical interventions in aging · 2022Trial
- Current Progress of Mechanisms Underlying Post-Stroke Depression and Music Therapy.Chinese journal of integrative medicine · 2026Review
- Insomnia and the Risk of Atrial Fibrillation: A Nationwide, Real-World Cohort Study.Journal of the American Heart Association · 2026Article
- Factors associated with antidepressant use following hospitalization for acute stroke.International journal of psychiatry in medicine · 2026Article
- Development and validation of a machine-learning model for the risk of potentially inappropriate medications in elderly stroke patients.Frontiers in pharmacology · 2025Article
- Post-stroke Everything.Current neurology and neuroscience reports · 2023Review
- Stroke Recovery Is a Journey: Prediction and Potentials of Motor Recovery after a Stroke from a Practical Perspective.Life (Basel, Switzerland) · 2023Article
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Authors and funding
15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
background and purposeDepression is common after stroke and is often treated with antidepressant medications (AD). ADs have also been hypothesised to improve stroke recovery, although recent randomised trials were neutral. We investigated the patterns of in-hospital AD initiation after ischaemic stroke and association with clinical and readmission outcomes.
methodsAll Medicare fee-for-service beneficiaries aged 65 or older hospitalised for ischaemic stroke in participating Get With The Guidelines-Stroke hospitals between April and December 2014 were eligible for this analysis. Outcome measures included days alive and not in a healthcare institution (home time), all-cause mortality and readmission within 1-year postdischarge. Propensity score (PS)-adjusted logistic regression models were used to evaluate the associations between AD use and each outcome measure. We also compared outcomes in patients prescribed selective serotonin reuptake inhibitors (SSRIs) AD versus those prescribed non-SSRI ADs.
resultsOf 21 805 AD naïve patients included in this analysis, 1835 (8.4%) were started on an AD at discharge. Patients started on an AD had higher rates of depression and prior ischaemic stroke, presented with higher admission National Institutes of Health Stroke Scale score and were less likely to be discharged home. Similarly, patients started on an SSRI had lower rates of discharge to home. Adjusting for stroke severity, patients started on an AD had worse all-cause mortality, all-cause readmission, major adverse cardiac events, readmission for depression and decreased home-time. However, AD use was also associated with an increased risk for the sepsis, a falsification endpoint, suggesting the presence of residual confounding.
conclusionsPatients with ischaemic stroke initiated on AD therapy are at increased risk of poor clinical outcomes and readmission even after PS adjustment, suggesting that poststroke depression requiring medication is a poor prognostic sign. Further research is needed to explore the reasons why depression is associated with worse outcome, and whether AD treatment modifies this risk or not.
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