Effect of selective serotonin re-uptake inhibitors (SSRIs) on functional outcome in patients with acute ischemic stroke treated with tPA.
BACKGROUND
Selective serotonin re-uptake inhibitors (SSRIs) may have therapeutic potential in the treatment of ischemic stroke by effects on neuronal cell survival and the plasticity of brain processes. In the present study, we investigated whether prior treatment with a SSRI is associated with more favorable functional outcome in a cohort of patients with acute ischemic stroke treated with tissue plasminogen activator (tPA).


METHODS
In a prospective observational cohort study of 476 acute ischemic stroke patients treated with tPA we investigated the relationship between prior SSRI treatment and functional outcome at 3 months. Ischemic stroke subtypes were defined according to the Oxfordshire Community Stroke Project Classification. Favorable outcome was defined as a modified Rankin Scale score <or=2.


RESULTS
In the cohort of 476 patients, 22 (5%) patients used a SSRI at stroke onset. At 3 months, 217 (46%) patients had a favorable outcome of whom 9 (41%) on SSRI treatment and 208 (46%) not using SSRIs (p=0.65). In a multivariable analysis SSRI treatment showed a trend to association with unfavorable outcome (OR 0.4, 95% CI 0.14-1.13, p=0.08). In the 376 patients with cortical stroke, SSRI treatment was associated with an unfavorable outcome (OR 0.17, 95% CI 0.04-0.73, p=0.017).


CONCLUSIONS
Our data suggest that in patients with acute ischemic stroke treated with tPA, prior SSRI use may be associated with a less favorable outcome, especially in cortical stroke.
Miedema
I
I
Department of Neurology, University Medical Centre Groningen, University of Groningen, The Netherlands. i.miedema@neuro.umcg.nl
Horvath
K M
KM
Uyttenboogaart
M
M
Koopman
K
K
Lahr
M M H
MM
De Keyser
J
J
Luijckx
G J
GJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D017367:Selective Serotonin Reuptake Inhibitors; D010959:Tissue Plasminogen Activator