Antidepressant use and stroke or mortality risk in the elderly

Abstract

Background and purpose: Current evidence on antidepressant-related stroke or mortality risk is inconsistent. Because the elderly have the highest exposure to antidepressants, the aim was to quantify their association with stroke and mortality risks in this vulnerable population. Methods: Persons over 65 years old and registered in the Information System for Research in Primary Care of Catalonia during 2010-2015 comprised the study population. Antidepressant exposure was categorized into current-users, recent-users, pastusers and antidepressant non-users (controls). The effect of antidepressant exposure on stroke or death, whichever came first, was analyzed by Cox regression adjusted for established risk factors. Results:Of the 1,068,117 participants included, 20% had antidepressant reimbursements during follow-up, 17% had a stroke and 3% died. The risk of experiencing stroke or death was higher in antidepressant current-users (hazard ratio [HR] 1.04; 95% confidence interval [CI] 1.02-1.06), recent-users (HR 3.34;) and past-users (HR 2.06; 95% CI 2.02-2.10) compared to antidepressant non-users. Antidepressant current-use was associated with increased stroke (HR 1.56; 95% CI 1.50-1.61) but decreased mortality risk (HR 0.93; 95% CI 0.91-0.94). During antidepressant recent-use and past-use, both stroke and mortality risks were significantly increased compared to no antidepressant use.Conclusions: Antidepressant use may be associated with increased stroke risk in the elderly. When using antidepressants in this population, the potential risks should be considered.

Recognition of the Possible miRNA-mRNA Controlling Network in Stroke by Bioinformatics Examination

“…The second most common cause of uncertain death around the world is stroke. It is also the primary cause of permanent neurodisability [ 1 , 2 ]. About 17 million stroke cases occur worldwide each year.…”

How antidepressants affect the cerebral ischemic injury and ischemic stroke

“…There are also studies showing that the risk of antidepressantrelated death was significantly lower during treatment but the risk was significantly increased after withdrawal of antidepressants. However, the current research on antidepressant treatment was found that antidepressants could reduce mortality, which reduced the rate of mortality by 10% compared with non-users [4]. This contradictory finding might be explained by the high risk of death of the elderly and the limitations of the survey.…”

“…What's more, the risk of stroke or mortality associated with antidepressants is inconsistent. The increased stroke risk may be related to antidepressants, especially in the elderly [4]. This paradoxical result is mainly due to the fact that antidepressants have a range of side effects that can be detrimental to stroke recovery.…”

The White Matter Functional Abnormalities in Patients with Transient Ischemic Attack: A Reinforcement Learning Approach

“…All patients underwent electrocardiography (ECG), carotid duplex ultrasound (CDU), and magnetic resonance imaging (MRI). The information of each patient was recorded as follows: history of TIA and stroke; current smoking and drinking behavior; previous risk factors such as hypertension, diabetes, and coronary artery disease [ 56 ]; medications used before MRI scan [ 57 ]; in-hospital assessment of arterial stenosis on CDU and magnetic resonance angiography (MR angiography); atrial fibrillation on ECG; brain infarction on diffusion-weighted imaging (DWI) and T2 fluid-attenuated inversion recovery (T2-FLAIR) [ 58 ]; and 1-year telephone follow-up for stroke and/or TIA episodes [ 59 ]. Participants with migraine, epilepsy, hemorrhage, leukoaraiosis, or psychiatric history were excluded from this study [ 60 ].…”