The Effects of Pretreatment versus De Novo Treatment with Selective Serotonin Reuptake Inhibitors on Short-term Outcome after Acute Ischemic Stroke

Objective: To determine if patients admitted with ischemic stroke who were taking selective serotonin reuptake inhibitors (SSRI) at baseline have reduced motor impairment compared to patients not taking an SSRI. Introduction: SSRI use may help patients with motor recovery following ischemic stroke. It is not known whether use of this class of medications prior to stroke leads to decreased stroke severity or motor impairment on admission and improved discharge outcome. Methods: We retrospectively identified all patients admitted to our institution between 2009 and 2012 with first-ever acute ischemic stroke who were taking an SSRI prior to admission (cases). We collected data on patient demographics, clinical stroke severity as measured by the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) score, and disposition at discharge. Controls with acute ischemic stroke who were not taking SSRIs prior to admission were matched 2:1 by age and gender to cases. Results: Eighty cases (mean age 65 +/- 14 years) were identified, of whom 56.2% were female and 63.7% were Caucasian. Median admission NIHSS was 5 (IQR 2-10), and median length of stay (LOS) was 4 days (IQR 3-7). Compared to controls, cases were more likely to have a pre-stroke diagnosis of depression (43.8% vs 7.5%, p=<0.001) or anxiety (13.8% vs 2.5%, p=0.001). Identification of a cardioembolic etiology was more common in cases (41.2% vs 26.6%, p=0.019). Median total NIHSS scores and NIHSS motor component scores on admission (total 5 vs 4, p=0.69; motor 2 vs 1, p=1.0) or at discharge (total 3.5 vs 2, p=0.67; motor 1 vs 0, p=0.76) were not different between cases and controls. Median LOS was similar for controls (5 days, p=0.65). Discharge to home or acute rehab was similar between groups (p=0.85). Conclusions: SSRI use prior to ischemic stroke does not confer a protective effect in reducing initial stroke severity, reducing degree of motor impairment, or improving discharge disposition. Further studies are needed to determine whether there are long-term benefits or other effects.

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Selective serotonin reuptake inhibitors to improve outcome in acute ischemic stroke: possible mechanisms and clinical evidence

Brain and Behavior ◽

10.1002/brb3.373 ◽

2015 ◽

Vol 5 (10) ◽

Cited By ~ 42

Author(s):

Timo Siepmann ◽

Ana Isabel Penzlin ◽

Jessica Kepplinger ◽

Ben Min‐Woo Illigens ◽

Kerstin Weidner ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Clinical Evidence ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Improve Outcome

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Role of some inflammatory biomarkers in prediction of short-term outcome in acute ischemic stroke

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00294-4 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Yosria Abd Al Hameed AlTaweel ◽

Rania Sanad Nageeb ◽

Pakinam Mahmoud Metwally ◽

Ahmed Elsayed Badawy

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Severity ◽

Short Term ◽

Laboratory Assessment ◽

Term Outcome ◽

Neutrophil Lymphocyte Ratio ◽

Short Term Outcome ◽

Wbc Count

Abstract Background Several factors affect acute ischemic stroke (AIS) outcomes. Objective This study aimed to assess the role of the leukocyte count, neutrophil/lymphocyte ratio (NLR), and c reactive protein (CRP) as early predictors of outcome in AIS patients. Methods This study was conducted on 60 AIS patients. They were subjected to detailed history taking, clinical examination, brain imaging, and laboratory assessment including the CRP, white blood cell (WBC) count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR which is calculated by dividing ANC by ALC. Neurological scales were used to assess the level of consciousness by the Glasgow Coma Scale (GCS) and stroke severity by the National Institute of Health Stroke Scale (NIHSS) at the first 48 h of stroke onset as well as 1 week and 2 weeks later for the assessment of short-term functional neurological outcome. Results Sixty percent of the patients had unfavorable outcomes assessed by the Modified Rankin Scale (mRS). Patients with unfavorable outcomes had higher NIHSS scores. NLR was positively correlated with WBC count, ANC, and CRP. The higher WBC, NLR, and NIHSS, the unfavorable the outcome was. Conclusion The higher WBC, the NLR, and the level of CRP at the onset of AIS, the more severe stroke and the poorer the short-term outcome are expected.

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