Impact of Prestroke Selective Serotonin Reuptake Inhibitor Treatment on Stroke Severity and Mortality

Background and Purpose—Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of bleeding but also a possible neuroprotective effect in stroke. We aimed to examine the implications of prestroke SSRI use in hemorrhagic and ischemic stroke. Methods—We conducted a registry-based propensity score–matched follow-up study among first-ever patients with hemorrhage and ischemic stroke in Denmark (2003–2012). Multiple conditional logistic regression was used to compute adjusted odds ratios of severe stroke and death within 30 days. Results—Among 1252 hemorrhagic strokes (626 prestroke SSRI users and 626 propensity score–matched nonusers), prestroke SSRI use was associated with an increased risk of the strokes being severe (adjusted propensity score–matched odds ratios, 1.41; confidence interval, 1.08–1.84) and an increased risk of death within 30 days (adjusted propensity score–matched odds ratios, 1.60; confidence interval, 1.17–2.18). Among 8956 patients with ischemic stroke ...