{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:15:15Z","timestamp":1776921315187,"version":"3.51.2"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Multiple studies have reported that the use of selective serotonin reuptake inhibitors (SSRIs) is associated with an increased risk of ischemic stroke; however, this finding may be the result of a confounding by indication. We examined the association using different approaches to minimize such potential bias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A nested case-control study was carried out in a Spanish primary health-care database over the study period 2001 to 2015. Cases were patients sustaining an ischemic stroke with no sign of cardioembolic or unusual cause. For each case, up to 5 matched controls (for exact age, sex, and index date) were randomly selected. Antidepressants were divided in 6 pharmacological subgroups according to their mechanism of action. The current use of SSRIs (use within a 30-day window before index date) was compared with nonuse, past use (beyond 365 days) and current use of other antidepressants through a conditional logistic regression model to obtain adjusted odds ratios and 95% CI. Only initiators of SSRIs and other antidepressants were considered.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 8296 cases and 37\u2009272 matched controls were included. Of them, 255 (3.07%) were current users of SSRIs among cases and 834 (2.24%) among controls, yielding an adjusted odds ratio of 1.14 (95% CI, 0.97\u20131.34) as compared with nonusers, 0.94 (95% CI, 0.77\u20131.13) as compared with past-users and 0.74 (95% CI, 0.58\u20130.93) as compared with current users of other antidepressants. No relevant differences were found by duration (\u22641, &gt;1 year), sex, age (&lt;70, \u226570 years old) and background vascular risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The use of SSRIs was not associated with an increased risk of noncardioembolic ischemic stroke. On the contrary, as compared with other antidepressants, SSRIs appeared to be protective.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.036661","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T10:00:21Z","timestamp":1643882421000},"page":"1560-1569","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Selective Serotonin Reuptake Inhibitors and Risk of Noncardioembolic Ischemic Stroke: A Nested Case-Control Study"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5539-7637","authenticated-orcid":true,"given":"Rasha","family":"Alqdwah-Fattouh","sequence":"first","affiliation":[{"name":"Unit of Epidemiology and Public Health. School of Medicine, University of Alcal\u00e1, Alcal\u00e1 de Henares, Madrid, Spain (R.A.-F., F.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3539-1470","authenticated-orcid":true,"given":"Sara","family":"Rodr\u00edguez-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."},{"name":"Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcal\u00e1 (IRYCIS), Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7200-3345","authenticated-orcid":true,"given":"Diana","family":"Barreira-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."},{"name":"Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcal\u00e1 (IRYCIS), Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8285-9809","authenticated-orcid":true,"given":"Laura","family":"Izquierdo-Esteban","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (L.I.-E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3827-9564","authenticated-orcid":true,"given":"Miguel","family":"Gil","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain (M.G., D.G.-B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5771-6072","authenticated-orcid":true,"given":"Diana","family":"Gonz\u00e1lez-Bermejo","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain (M.G., D.G.-B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9477-7977","authenticated-orcid":true,"given":"Encarnaci\u00f3n","family":"Fern\u00e1ndez-Ant\u00f3n","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."},{"name":"Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcal\u00e1 (IRYCIS), Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-1612","authenticated-orcid":true,"given":"Antonio","family":"Rodr\u00edguez-Miguel","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."},{"name":"Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcal\u00e1 (IRYCIS), Alcal\u00e1 de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-2584","authenticated-orcid":true,"given":"Alberto","family":"Garc\u00eda-Lled\u00f3","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain (A.G.-L.)."},{"name":"Department of Medicine, School of Medicine, University of Alcal\u00e1, Alcal\u00e1 de Henares, Madrid, Spain (A.G.-L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Bol\u00famar","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Public Health. 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