Retrospective analysis of acute ischemic stroke shows timing of antidepressant use associated with short-term recovery and functional independence at 90-days.

Publication Title

NeuroRehabilitation

Authors

Elizabeth Baraban, Center for Cardiovascular Analytics, Research +, Data Science, Providence St. Vincent Medical Center, Portland, OR, USA.Follow
Alyx Lesko, Providence Brain and Spine Institute, Providence St. Vincent Medical Center, Portland, OR, USA.Follow
Kyle Still
Weston Anderson, Providence Brain and Spine Institute, Providence St. Vincent Medical Center, Portland, OR, USA.Follow

Document Type

Article

Publication Date

1-1-2024

Keywords

oregon; portland; cards; cards publication; Humans; Male; Female; Retrospective Studies; Antidepressive Agents; Middle Aged; Aged; Recovery of Function; Ischemic Stroke; Time Factors; Stroke Rehabilitation; Treatment Outcome; Aged, 80 and over

Abstract

BACKGROUND: Little is known about how the timing of antidepressant use influences stroke outcomes. Previous research shows conflicting results on the impact of a new antidepressant prescription on stroke recovery.

OBJECTIVE: The objective of this exploratory, retrospective analysis is to examine stroke outcomes by timing of antidepressant use among patients who received stroke treatment.

METHODS: 12,590 eligible patients were treated for a primary or secondary diagnosis of ischemic stroke. The outcome variables were a change in ambulation or modified Rankin scale (mRs) from pre-stroke to discharge; and a change in mRS from pre-stroke to 90-days post-discharge. The independent variable of interest was timing of antidepressant treatment. Logistic regression with generalized estimating equations was used, controlling for covariates.

RESULTS: Our model predicted that a new antidepressant prescription at discharge was associated with a ∼7% decrease in the likelihood of returning to baseline functional independence at 90-days compared to patients currently using an antidepressant (AOR:0.510, CI:0.277-0.938, p = 0.03).

CONCLUSION: These results suggest that use of antidepressants was associated with stroke recovery, but the effects are moderated by sex. Further study is needed to determine if this relationship is causal and the mechanisms between timing of antidepressant treatment and outcomes.

Clinical Institute

Cardiovascular (Heart)

Clinical Institute

Mental Health

Clinical Institute

Neurosciences (Brain & Spine)

Specialty/Research Institute

Cardiology

Specialty/Research Institute

Neurosciences

Specialty/Research Institute

Epidemiology

DOI

10.3233/NRE-240037