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BMC Neurology
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Research article

Using antidepressants and the risk of stroke recurrence: report from a national representative cohort study

Authors: Hsiao-Ting Juang, Pei-Chun Chen, Kuo-Liong Chien

Published in: BMC Neurology | Issue 1/2015

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Abstract

Background

Evidence about the association between antidepressants and the risk of stroke recurrence was scanty. This study evaluated the risk of stroke recurrence according to using antidepressants in patients with stroke from a national representative cohort.

Methods

This cohort study followed 16770 patients aged > =20 years who had an incident stroke from 2000 to 2009 from the National Health Insurance Research Database in Taiwan. Records of each antidepressant prescription were obtained during follow-up. The types of antidepressants were categorized by Anatomical Therapeutic Chemical classification system: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and other antidepressants. The main outcome was a recurrent stroke during the follow-up period. The time-dependent Cox proportional hazards model was used in the analyses.

Results

During 63715 person-years of follow-up, we documented 3769 events for stroke recurrence. Antidepressants use was associated with an increased risk of stroke recurrence (adjusted hazard ratio [HR], 1.42; 95 % confidence interval [C.I.], 1.24–1.62), especially for ischemic stroke (HR, 1.48; 95 % C.I., 1.28–1.70), but not for hemorrhagic stroke (HR, 1.22; 95 % C.I., 0.86–1.73). The increased risk of stoke recurrence was found for TCAs use only (HR, 1.41; 95 % C.I., 1.14–1.74), SSRIs use only (HR, 1.31; 95 % C.I.,1.00–1.73),use of other types of antidepressants only(HR, 1.46; 95 % C.I.,1.15–1.84), or use of multiple types of antidepressants (HR, 1.84; 95 % C.I.,1.04–3.25).

Conclusions

We demonstrated that use of antidepressants was associated with an increased risk of stroke recurrence, especially in ischemic stroke among Taiwanese. Further studies are warranted to confirm the possible underlying mechanisms of these findings.
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Metadata
Title
Using antidepressants and the risk of stroke recurrence: report from a national representative cohort study
Authors
Hsiao-Ting Juang
Pei-Chun Chen
Kuo-Liong Chien
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0345-x

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