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Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis

Cited 45 time in Web of Science Cited 51 time in Scopus
Authors
Shin, Doosup; Oh, Yun Hwan; Eom, Chun-Sick; Park, Sang Min
Issue Date
2014-04
Publisher
Springer Verlag
Citation
Journal of Neurology, Vol.261 No.4, pp. 686-695
Keywords
복합학StrokeSelective serotonin reuptake
inhibitors
AntidepressantsMeta-analysis
Abstract
Since several studies have inconsistently reported the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of stroke, we performed a meta-analysis on this issue. We identified studies by searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to August, 2013. Pooled effect estimates were obtained by using random-effects meta-analysis. Thirteen relevant studies (three case-control, six nested case-control, and four cohort studies) were finally included in our study. In our meta-analyses, the use of SSRIs was associated with an increased risk of all types of stroke [adjusted odds ratio (aOR), 1.40; 95 % confidence interval (CI), 1.09-1.80], ischemic stroke (aOR 1.48; 95 % CI 1.08-2.02), and hemorrhagic stroke (aOR 1.32; 95 % CI 1.02-1.71). Between the two subtypes of hemorrhagic stroke, that is, intracerebral and subarachnoid, the increased risk of intracerebral hemorrhage was associated with the use of SSRIs (aOR 1.30; 95 % CI 1.02-1.67). When the analysis was restricted to the studies in which potential confounding by depression was considered, the risks were still higher in SSRI users than in non-users and the heterogeneities among studies were significantly decreased. Since there was heterogeneity among studies and a possible confounding effect from depression could not be fully excluded, further well-designed studies are needed to confirm this association.
ISSN
0340-5354
Language
English
URI
http://hdl.handle.net/10371/94240
DOI
https://doi.org/10.1007/s00415-014-7251-9
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College of Medicine/School of Medicine (의과대학/대학원)Family Medicine (가정의학전공)Journal Papers (저널논문_가정의학전공)
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