{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:16:23Z","timestamp":1790226983475,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Selective serotonin reuptake inhibitors (SSRIs) have a well-established association with bleeding complications and conflicting reports on outcome after stroke. We sought to evaluate whether pre\u2013intracerebral hemorrhage (ICH) SSRI use increased ICH risk and post-ICH SSRI use improved ICH outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Through post hoc analysis of the ERICH study (Ethnic\/Racial Variations of Intracerebral Hemorrhage), SSRI use was categorized into no use, pre-ICH only, pre- and post-ICH use (termed \u201ccontinuous\u201d), and post-ICH only (termed \u201cnew\u201d). Using multivariable modeling, associations were sought between pre-ICH SSRI use and ICH risk in the case-control set, and associations between post-ICH SSRI use and 3-month outcome were analyzed in the ICH case set. Exploratory analyses sought to assess influence of race\/ethnicity in models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              The final study cohort consisted of 2287 ICH cases and 2895 controls. Pre-ICH SSRI use was not associated with ICH risk (odds ratio, 0.824 [95% CI, 0.632\u20131.074]) nor potentiation of ICH risk with anticoagulant or antiplatelet use. New post-ICH SSRI use was associated with unfavorable modified Rankin Scale score at 3 months after ICH (odds ratio, 1.673 [95% CI, 1.162\u20132.408];\n              <jats:italic>P<\/jats:italic>\n              =0.006) in multivariable analyses. Additional propensity score analysis indicated a similar trend but did not reach statistical significance (\n              <jats:italic>P<\/jats:italic>\n              =0.107). When stratified by race\/ethnicity, multivariable modeling demonstrated reduced ICH risk with pre-ICH SSRI use in Hispanics (odds ratio, 0.513 [95% CI, 0.301\u20130.875];\n              <jats:italic>P<\/jats:italic>\n              =0.014), but not non-Hispanic whites or blacks, and no associations between post-ICH SSRI use and 3-month outcome in any racial\/ethnic group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In a large multiethnic cohort, pre-ICH SSRI use was not associated with increased ICH risk, but post-ICH SSRI use was associated with unfavorable 3-month neurological outcome after ICH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01202864.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.119.028406","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T18:58:13Z","timestamp":1584557893000},"page":"1135-1141","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Selective Serotonin Reuptake Inhibitors and Intracerebral Hemorrhage Risk and Outcome"],"prefix":"10.1161","volume":"51","author":[{"given":"Li","family":"Liu","sequence":"first","affiliation":[{"name":"From the Department of Neurology (L.L.), PLA Strategic Support Force Characteristic Medical Center, Beijing, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology (M.F., M.J.L.), Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler P.","family":"Behymer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (T.P.B., D.W.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisi","family":"Ng","sequence":"additional","affiliation":[{"name":"Duke-NUS Graduate Medical School, Singapore (Y.N., N.K.K.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Christianson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Tennessee, Knoxville (T.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyansh","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.S., M.L.J.), Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas Kon Kam","family":"King","sequence":"additional","affiliation":[{"name":"Duke-NUS Graduate Medical School, Singapore (Y.N., N.K.K.K.)"},{"name":"National Neuroscience Institute, Singapore (N.K.K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (T.P.B., D.W.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8715-5210","authenticated-orcid":false,"given":"Michael L.","family":"James","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.S., M.L.J.), Duke University, 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