Retrospective analysis of acute ischemic stroke shows timing of antidepressant use associated with short-term recovery and functional independence at 90-days
Affiliations: [a] Center for Cardiovascular Analytics, Research +, Data Science, Providence St. Vincent Medical Center, Portland, OR, USA
| [b] Providence Brain and Spine Institute, Providence St. Vincent Medical Center, Portland, OR, USA
| [c] College of Osteopathic Medicine of the Pacific-Northwest, Western University of Health Sciences, Lebanon, OR, USA
Correspondence:
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Address for correspondence: Elizabeth Baraban, MPH, PhD, Center for Cardiovascular Analytics, Research and Data Science, Providence St Joseph Health, 9427 SW Barnes Rd, Suite 594, Portland, OR 97225, USA. Tel.: +1 818 726 6332; E-mail: elizabeth.baraban@providence.org.
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.
