SSRIs may protect against noncardioembolic ischaemic stroke

Use of selective serotonin reuptake inhibitors (SSRIs) poses no risk of noncardioembolic ischaemic stroke and is even protective when compared with other antidepressants, according to a recent study.

In the study, researchers used data from a Spanish primary healthcare database and conducted a nested case-control study. The population involved patients sustaining an ischaemic stroke with no sign of cardioembolic or unusual cause. Each patient was matched with up to five randomly selected controls based on age, sex, and index date.

Antidepressants were categorized in six pharmacological subgroups according to their mechanism of action. Current SSRI use was defined as exposure to the antidepressant within a 30-day window before index date.

The analysis included a total of 8,296 patients and 37,272 matched controls. The number of current SSRI users was 255 (3.07 percent) in the case group and 834 (2.24 percent) in the control group.

In multivariable conditional logistic regression model, the odds ratios for noncardioembolic ischaemic stroke associated with current SSRI use were 1.14 (95 percent confidence interval [CI], 0.97–1.34) as compared with nonuse, 0.94 (95 percent CI, 0.77–1.13) as compared with past use (beyond 365 days), and 0.74 (95 percent CI, 0.58–0.93) as compared with current use of other antidepressants.

The estimates did not vary much across subgroups defined by duration (≤1 vs >1 year), sex, age (<70 vs ≥70 year), and background vascular risk.