Antidepressants on Stroke Outcomes Assessing the Effects of Antidepressant Use on Stroke Recurrence and Related Outcomes in Ischemic Stroke Patients: A Propensity Score Matched Analysis

Faisal F. Alamri ^1,2* Daniyah A. Almarghalani ^3,4 Yasser Alatawi ⁵ Eman Alraddadi ^2,6 Omar Babateen ⁷ Ahmed Alayyafi ⁸ Ziyad Almalki ⁸ Khaled Alsalhi ⁸ Khaled Alzahrani ⁸ Ahmed Abdulrahman Alghamdi ⁹ Hussein Aldera ⁹ Vardan T. Karamyan ^10,11

• ¹ King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
• ² King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
• ³ Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Saudi Arabia
• ⁴ Stroke Research Unit, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia., Taif, Saudi Arabia
• ⁵ Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
• ⁶ Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Jeddah, Saudi Arabia
• ⁷ Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, Makkah, Saudi Arabia
• ⁸ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Riyadh, Saudi Arabia
• ⁹ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
• ¹⁰ Department of Foundational Medical Studies, Oakland University, Rochester, MI, 48309, USA, Rochester, United States
• ¹¹ Laboratory for Neurodegenerative Disease & Drug Discovery, William Beaumont School of Medicine, Oakland University, Rochester, Michigan 48309, United States, Rochester, United States

The effect of antidepressant use, particularly that of selective serotonin reuptake inhibitors, on stroke outcomes remains unclear. This hospital-based, retrospective, observational study utilized propensity score-matching (PSM) to assess the association between antidepressant use, stroke-related outcomes, and complications. The study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah and Riyadh and included 1,125 patients with acute-subacute ischemic stroke, of whom 1,025 were antidepressant non-users and 100 antidepressant users. After PSM, 200 patients (100 antidepressant users and 100 non-users) were included in the final analysis. This study aimed to assess the association between antidepressant use, stroke recurrence, and mortality. Additionally, the study examined the association between antidepressant use and stroke severity, functional independence, and incidence of post-stroke complications. The Kaplan-Meier analysis revealed no statistically significant differences in stroke recurrence (p = 0.5619) or mortality (p = 0.6433) between antidepressant users and non-users over the one-year follow-up period. Additionally, no significant differences were observed in stroke severity at admission and discharge (p = 0.33210 and p = 0.78410, respectively) or functional independence (p = 0.9176 and p = 0.4383, respectively) between the two groups. These findings suggest that antidepressant use does not significantly affect stroke recurrence, mortality, stroke severity, or functional independence. However, further large-scale studies are warranted to validate these findings and investigate potential confounding factors, such as stroke subtypes, co-use of certain medications, and physical activity.