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Stroke and ssri

Christine Leong, Silvia Alessi-Severini, Murray W Enns, Yao Nie, Jitender Sareen, James Bolton, Heather J Prior, Dan Chateau
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are widely prescribed for mood and anxiety disorders. However, it is not clear whether SNRIs are more strongly associated with cardiovascular and cerebrovascular events than SSRIs. METHODS: This was a propensity score-matched, population-based, cohort study of Manitobans who started an SSRI or SNRI between April 1, 1998, and March 31, 2014. The primary outcome was a composite of acute myocardial infarction (AMI), stroke, or cardiovascular-related hospitalization within 1 year of drug initiation...
June 2017: Journal of Clinical Psychopharmacology
Chien-Chen Chou, Der-Jen Yen, Yung-Yang Lin, Yu-Chiao Wang, Cheng-Li Lin, Chia-Hung Kao
OBJECTIVE: To investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on poststroke epilepsy in a population-based nationwide study. PATIENTS AND METHODS: The SSRI group included patients who received a stroke diagnosis from January 1, 2000, through December 31, 2009, and were prescribed SSRIs after stroke. The non-SSRI group enrolled patients with stroke who were not prescribed SSRIs from the Taiwan National Health Insurance Research Database and used propensity score matching based on the index year, duration time, sex, age, type of stroke, and duration of hospitalization...
February 2017: Mayo Clinic Proceedings
Samir R Belagaje
PURPOSE OF REVIEW: Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. RECENT FINDINGS: Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset...
February 2017: Continuum: Lifelong Learning in Neurology
Tze Chao Wee
We report on a patient who developed massive gastrointestinal hemorrhage related to the use of fluoxetine in combination with aspirin and clopidogrel. A 58-year-old man was admitted with a posterior circulation infarct with significant weakness in all four limbs and dysarthria. Aspirin and clopidogrel were started. Fluoxetine was started for pharmacological neurostimulation to promote motor recovery and for low mood. He developed gastrointestinal hemorrhage a week after fluoxetine was started. Fluoxetine was suspended and investigations failed to reveal the source of the bleeding...
January 30, 2017: American Journal of Physical Medicine & Rehabilitation
Katsiaryna Bykov, Sebastian Schneeweiss, Macarius M Donneyong, Yaa-Hui Dong, Niteesh K Choudhry, Joshua J Gagne
Clopidogrel is a pro-drug that requires activation by the cytochrome P450 (CYP) enzyme system. Patients receiving clopidogrel are often treated with selective serotonin reuptake inhibitors (SSRIs) for co-existing depression. SSRIs that inhibit the CYP2C19 enzyme have the potential to reduce the effectiveness of clopidogrel. Using 5 US databases (1998 to 2013), we conducted a cohort study of adults who initiated clopidogrel while being treated with either an SSRI that inhibits CYP2C19 (fluoxetine and fluvoxamine) or a noninhibiting SSRI...
November 16, 2016: American Journal of Cardiology
Benjamin A Abramoff, S Byron Milton, Samir R Belagaje
Homonymous hemianopsia (HH) is a common adverse outcome after stroke. Spontaneous improvement more than 6 months poststroke is thought to be unlikely, and traditional visual rehabilitation techniques lack clear evidence of efficacy. The case presented is of a 22-year-old woman who demonstrated improved compensation of her stroke-induced HH after the initiation of a selective serotonin reuptake inhibitor (SSRI). There is evidence supporting the use of SSRIs to improve poststroke cognitive impairment, motor impairment, and depression...
November 18, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Benjamin A Abramoff, Samir Belagaje, Samuel Milton
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Che-Sheng Chu, Po-Han Chou, Ching-Heng Lin, Chin Cheng, Chia-Jui Tsai, Tsuo-Hung Lan, Min-Wei Huang, Gerald Nestadt
BACKGROUND: Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). METHODS: A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009...
2016: PloS One
Leila Mnif, Rim Sellami, Jawaher Masmoudi
INTRODUCTION: Post-stroke emotional incontinence and bipolar disorder are two disorders that involve the dysfunction of brain structures responsible for emotional regulation. The objective of this work is to study the links between these disorders through a clinical case. CASE REPORT: We present the case of a 43-year-old man without previous psychiatric history who experienced emotional incontinence after cerebrovascular events. He reacted promptly to selective serotonin reuptake inhibitor treatment...
2016: Neuropsychiatric Disease and Treatment
Wataru Matsuura, Shinichi Harada, Shogo Tokuyama
Central post-stroke pain (CPSP), a potential sequela of stroke, is classified as neuropathic pain. Although we recently established a CPSP-like model in mice, the effects of adjuvant analgesics as therapeutic drugs for neuropathic pain in this model are unknown. Hence, the aim of the present study was to assess the usefulness of our model by evaluating the effects of adjuvant analgesics used for treating neuropathic pain in this mouse model of CPSP. Male ddY mice were subjected to 30 min of bilateral carotid artery occlusion (BCAO)...
2016: Biological & Pharmaceutical Bulletin
M Würtz, M Schmidt, E L Grove, E Horváth-Puhó, C F Christiansen, H T Sørensen
BACKGROUND: Patients with diabetes have an increased risk of stroke with a poor prognosis. Moreover, diabetic patients are at increased risk of depression and therefore likely to use selective serotonin reuptake inhibitors (SSRIs). We examined whether preadmission SSRI use was associated with increased mortality in diabetic patients hospitalized due to stroke. METHODS: Population-based medical databases were used to identify all first-time stroke-related hospitalizations and subsequent mortality in diabetic patients in Denmark between 2004 and 2012 (n = 12 620)...
October 2016: Journal of Internal Medicine
Bilal Khokhar, Linda Simoni-Wastila, Jennifer S Albrecht
OBJECTIVE: To estimate the risk of stroke associated with new antidepressant use among older adults with traumatic brain injury (TBI). PARTICIPANTS: A total of 64 214 Medicare beneficiaries aged 65 years or older meeting inclusion criteria and hospitalized with a TBI during 2006 to 2010. DESIGN: New user design. Generalized estimating equations were used to estimate the relative risks (RRs) of stroke. MAIN MEASURES: Primary exposure was new antidepressant use following TBI identified through Medicare part D claims...
January 2017: Journal of Head Trauma Rehabilitation
Anke Booker, Jens Bohlken, Michael A Rapp, Karel Kostev
BACKGROUND: The aims of the present study are to determine what proportion of patients with dementia receives antidepressants, how long the treatment is administered, and what factors increase the risk of discontinuation. METHODS: The study was based on Disease Analyzer database and included 1,203 general practitioners (GP) and 209 neurologists/psychiatrists (NP). 12,281 patients with a diagnosis of dementia and an initial prescription of an antidepressant drug between January 2004 and December 2013 were included...
May 2016: International Journal of Clinical Pharmacology and Therapeutics
Carol Coupland, Trevor Hill, Richard Morriss, Michael Moore, Antony Arthur, Julia Hippisley-Cox
OBJECTIVE: To assess associations between different antidepressant treatments and rates of three cardiovascular outcomes (myocardial infarction, stroke or transient ischaemic attack, and arrhythmia) in people with depression. DESIGN: Cohort study. SETTING: UK general practices contributing to the QResearch primary care database. PARTICIPANTS: 238,963 patients aged 20 to 64 years with a first diagnosis of depression between 1 January 2000 and 31 July 2011...
2016: BMJ: British Medical Journal
Han Shan, Yaqi Bian, Zhaoma Shu, Linxia Zhang, Jialei Zhu, Jianhua Ding, Ming Lu, Ming Xiao, Gang Hu
Fluoxetine, a selective serotonin reuptake inhibitor, exerts neuroprotective effects in a variety of neurological diseases including stroke, but the underlying mechanism remains obscure. In the present study, we addressed the molecular events in fluoxetine against ischemia/reperfusion-induced acute neuronal injury and inflammation-induced neuronal apoptosis. We showed that treatment of fluoxetine (40 mg/kg, i.p.) with twice injections at 1 h and 12 h after transient middle cerebral artery occlusion (tMCAO) respectively alleviated neurological deficits and neuronal apoptosis in a mouse ischemic stroke model, accompanied by inhibiting interleukin-1β (IL-1β), Bax and p53 expression and upregulating anti-apoptotic protein Bcl-2 level...
August 2016: Neuropharmacology
Yen-Chieh Lee, Chin-Hsien Lin, Min-Shung Lin, Yun Lu, Chia-Hsuin Chang, Jou-Wei Lin
BACKGROUND: Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with an increased risk of intracranial hemorrhage. However, little is known about cerebrovascular risk in users of serotonin-norepinephrine reuptake inhibitors (SNRIs). Our aim was to determine the differential risk of cerebrovascular events between SSRIs and SNRIs. METHOD: A nationwide population-based cohort study was conducted in adult patients who started taking SSRIs or SNRIs during the time period 2005 through 2009...
January 2016: Journal of Clinical Psychiatry
Cynthia Wei-Sheng Lee, Cheng-Li Lin, Fung-Chang Sung, Ji-An Liang, Chia-Hung Kao
OBJECTIVE: We investigated the relationship between antidepressant use and the risk of subsequent dementia development. METHOD: A population-based retrospective case-control analysis was conducted using the Taiwan National Health Insurance Research Database. From patients enrolled in the National Health Insurance program between 2005 and 2011, we identified 2 subsets: 5,394 cases, who had major depression in 1997-2004 and subsequently were diagnosed with dementia (ICD-9-CM code 290) in 2005-2011, and 5,232 controls, who had major depression in 2005-2011 but no dementia history...
January 2016: Journal of Clinical Psychiatry
Meisha L Raven, Alexander L Ringeisen, Angela R McAllister, Daniel W Knoch
A 45-year-old woman with a history of depression and anxiety, treated with selective serotonin reuptake inhibitors (SSRIs), experienced acute, recurrent, and severe bifrontal headaches. Over time, she developed a left homonymous hemianopia and mental status changes. MRA revealed segmental vasoconstriction of cerebral arteries in multiple vascular distributions. She was treated with a calcium-channel blocker and magnesium, and there was resolution of her symptoms and cerebrovascular changes. Her clinical course and neuroimaging findings were consistent with reversible cerebral vasoconstriction syndrome...
June 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Salma A Ayis, Luis Ayerbe, Siobhan L Crichton, Anthony G Rudd, Charles D A Wolfe
BACKGROUND: The natural history of depression in stroke patients is complex and the mechanism of change in symptoms over time is not fully understood. We hypothesise that there are different trajectories of symptoms after stroke. METHODS: The primary analysis comprised 761 patients who completed 5 years follow up, obtained from the prospective South London Stroke Register (1998-2013). The Hospital Anxiety and Depression scale (HADs) was used to screen patients for depression symptoms at 3 months after stroke, then annually...
April 2016: Journal of Affective Disorders
Richard A Hansen, Yulia Khodneva, Stephen P Glasser, Jingjing Qian, Nicole Redmond, Monika M Safford
BACKGROUND: Mixed evidence suggests that second-generation antidepressants may increase the risk of cardiovascular and cerebrovascular events. OBJECTIVE: To assess whether antidepressant use is associated with acute coronary heart disease (CHD), stroke, cardiovascular disease (CVD) death, and all-cause mortality. METHODS: Secondary analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) longitudinal cohort study were conducted...
April 2016: Annals of Pharmacotherapy
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