title: Safety of selective serotonin reuptake inhibitor treatment in recovering stroke patients.
abstract: BACKGROUND
  Selective serotonin reuptake inhibitors (SSRIs) are widely used for psychiatric complications after stroke. Studies have indicated additional effects, and SSRIs could potentially be used as enhancers of stroke recovery. However, beneficial effects should be weighed against potential adverse effects. In particular, the possible association with cerebrovascular events has raised concern.
  
  
  METHODS
  We review the literature on cerebrovascular events associated with SSRI treatment after stroke. The possible beneficial effects of SSRI treatment for stroke recovery and survival, and potential safety concerns, are discussed.
  
  
  CONCLUSIONS
  Evidence suggests that SSRIs may enhance stroke recovery. Most studies on cerebrovascular risk are from non-stroke populations and little is known about recurrent events and mortality post-stroke. In non-stroke populations treatment has been associated with increased risk of intracerebral and intracranial hemorrhage; however the absolute risk is low. The association between SSRIs and ischemic stroke is less clear. Randomized stroke trials indicate that treatment is safe and well tolerated, and the most common side effects are often benign and transient. The trials are small however and not powered to detect potential differences in cerebrovascular events. We await several ongoing large randomized trials before SSRIs can be recommended as a routine pharmacotherapy in stroke recovery.
authors.affiliation: Aarhus University Hospital, Department of Neurology , Nørrebrogade 44, 8000 Aarhus C , Denmark +4578463335 ; +4578463300 ; janne.k.mortensen@clin.au.dk.
authors.forename: Janne Kaergaard
authors.initials: JK
authors.lastname: Mortensen
authors.forename: Grethe
authors.initials: G
authors.lastname: Andersen
mesh_terms: D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy* / Q000523:psychology; D000071939:Stroke Rehabilitation
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: antithrombotic; benefit; risk; selective serotonin reuptake inhibitors; stroke