Antidepressant Usage at Time of Stroke is Related to Better Mental Functioning

Damush TM, Lincoln F, Saha C, Slaven J, Myers L, Mackey J, Williams LS. Antidepressant Usage at Time of Stroke is Related to Better Mental Functioning. [Abstract]. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2017 Mar 1; 51(Suppl 1):S503.

Objective: An acute stroke may serve as a major life event that disrupts health-related quality of life. Post stroke depressant is prevalent and related to poorer outcomes. We examined the potential buffering relationship of antidepressants at time of stroke on mental health functioning among patients discharged from two health care systems: Veterans Health Administration (VHA) and a Joint Commission Stroke Center. Methods: We enrolled 258 participants into a randomized controlled trial to evaluate a stroke self-management program which targeted functional recovery and risk factor management. All participants completed written consent and a baseline assessment which included demographics, anxiety (GAD), depressive symptoms (PHQ9), antidepressant usage, stroke specific, health-related quality of life (SSQoL) and pain (BPI). We conducted multivariate analyses to evaluate the relationship of antidepressant usage with baseline mental functioning. Results: We enrolled our sample, on average, within 81.5 days after hospital discharge for stroke/TIA. Our sample included 19% women with an average age of 61.7 (10.8) years. The average NIH stroke scale score was 3.0 indicating minor stroke and did not differ among those with and without antidepressants. Demographics were not significantly related to SSQoL in the multivariate models. Among our cohort, 201 (78%) reported baseline usage. Among those using antidepressants, a significantly less proportion (26.4%) reported moderate to severe depressive symptoms compared to those who reported no usage (53.7%) Conclusions: Stroke survivors reporting antidepressant usage reported moderate to severe depression symptoms at half the rate of stroke survivors without antidepressant usage. Antidepressant usage at the time of a stroke event may buffer the development of poorer mental health functioning. Post stroke depression is prevalent and associated with morbidity and mortality. Therefore, post stroke programs which target depression at the early onset of survivorship may enhance stroke specific, quality of life.