Study finds two common types of antidepressants were safe for most stroke survivors

Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants.

DALLAS — Most stroke survivors were able to safely take two types of common antidepressants, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

Among people with ischemic (clot-caused) stroke, those who began taking an antidepressant known as an SSRI (selective serotonin reuptake inhibitor) and/or an SNRI (serotonin and norepinephrine reuptake inhibitor) for the common conditions of post-stroke depression and anxiety, did not have an increased risk of hemorrhagic (bleeds) stroke or other serious bleeding. This included people taking anticoagulation medications. There was, however, an increased risk of hemorrhagic stroke among stroke patients taking two anti-platelet medications, also called dual anti-platelet therapy or DAPT.

“Mental health conditions, such as depression and anxiety, are very common yet treatable conditions that may develop after a stroke. Our results should reassure clinicians that for most stroke survivors, it is safe to prescribe SSRI and/or SNRI antidepressants early after stroke to treat post-stroke depression and anxiety, which may help optimize their patients’ recovery,” said study lead author Kent P. Simmonds, D.O., Ph.D., a third-year physical medicine and rehabilitation resident at the University of Texas Southwestern Medical Center in Dallas. “However, caution is needed when considering the risk-benefit profile for stroke patients receiving dual anti-platelet therapy because we did find an increased risk of bleeding among this group.”

According to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update, when considered separately from other cardiovascular diseases, stroke ranks fifth among all causes of death, behind diseases of the heart, cancer, COVID-19 and unintentional injuries/accidents. Approximately one-third of stroke survivors develop poststroke depression. If left untreated, depression may affect quality of life and reduce the chances for optimal poststroke recovery such as returning to their usual daily living activities without assistance.

The most common classes of antidepressants are SSRIs or SNRIs, and they are widely used and effective for treating anxiety and depression. However, they may not be prescribed at all or early enough after a stroke, when the risk of depression or anxiety is particularly high, due to concerns that they may increase the risk of a hemorrhagic stroke or other serious types of bleeding.

Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants (such as sertraline, fluoxetine, citalopram, venlalfaxine). Serious bleeding was defined as bleeding in the brain, digestive tract; and shock, which occurs when bleeding prevents blood from reaching the body’s tissues.

Researchers also investigated serious bleeding among stroke survivors who took antidepressants combined with different types of blood-thinning medications that are used to prevent future blood clots. These blood-thinning medications may include either anticoagulants or antiplatelet medications. Anticoagulants are prescribed as a single medication and include medications such as warfarin, apixaban and rivaroxaban. Antiplatelet medications may be prescribed as either a single medication (commonly aspirin) or two types of antiplatelet medications can be used in dual antiplatelet therapy. DAPT includes aspirin plus another antiplatelet medication called a P2Y12 inhibitor (such as clopidogrel, prasugrel or ticagrelor).

The study found:

  • SSRI and SNRIs were generally safe to start during the important early stages of recovery as patients taking these medications were not more likely to develop serious bleeding compared to stroke survivors who did not take an antidepressant. This included ischemic stroke patients who are also taking anti-coagulation therapy.
  • An increased risk of serious bleeding occurred when SSRIs or SNRIs were taken in combination with DAPT treatments (aspirin and blood thinners). However, the overall risk remained low as serious bleeding events were rare.
  • Among ischemic stroke patients on antidepressant medications, there was a 15% increase in the risk of serious bleeding when taking medications from classes such as mirtazapine, bupropion and tricyclics compared to SSRI/SNRIs.
  • “Maximizing rehabilitation early after a stroke is essential because recovery is somewhat time-dependent, and most functional gains occur during the first few months after a stroke,” Simmonds said. “Fortunately, dual antiplatelet therapy is often administered for 14, 30 or 90 days, so, when indicated, clinicians may not need to withhold antidepressant medications for prolonged periods of time. Future research should investigate the risk of bleeding associated with the use of anti-depressant and anxiety medications among patients with hemorrhagic or bleeding stroke.”

    According to a 2022 American Heart Association scientific statement, social isolation and loneliness are associated with about a 30% increased risk of heart attack or stroke, or death from either. “Depression may lead to social isolation, and social isolation may increase the likelihood of experiencing depression. The current study helps answer safety issues around the use of antidepressants for treatment of mental health issues that may develop after a stroke,” said Crystal Wiley Cené, M.D., M.P.H., FAHA, chair of the writing group for the Association’s scientific statement, and a professor of clinical medicine and chief administrative officer for health equity, diversity and inclusion at the University of California San Diego Health. Dr. Cené was not involved in this study.


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    Unity High School announced first semester honor roll students

    The students named below earned recognition for their academic performance and attention to excellence at Unity High School. Congratulations to each on their exceptional scholastic effort last semester.

    Seniors

    High Honors: Evelyn Albaugh; Connor Cahill; Analyse Carter; Rebecca Carter; Brenlee Dalton; Taylor Drennan; Natalie Ellars; Bailey Grob; Brooklyn Haas; Madison Henry; Shelby Hoel; Margaret Ingleman; Caroline Jamison; Eden Johnson; Cassidy Keller; Caelyn Kleparski; Jocelyn LeFaivre; Reagan Little; Tatum Meyer; Eric Miebach; Lauren Neverman; Dean Niswonger; Anna Polonus; Aiden Porter; Meredith Reed; Maci Richmond; Briana Ritchie; Aubrey Sanders; Tsihon Shotton; Logan Siuts; Carsyn Smith; Piper Steele; Lily Steffens; Brock Suding; Ruby Tarr; Andrew Thomas; Darren Weckle; Erica Woodard; Abigail Woolcott; Emberly Yeazel; Ava Price; Erin Sanders; Bayleigh Jones; Isaac Ruggieri; Jeremy Wells; Madysen York; Brooke Hewing; Kendra Cromwell; Emma Plackett; Alexis Ritchie; Lynndsay Talbott; and Henry Thomas.

    Honor Roll: Emma Fish; Trevor McCarter; Keaton Roether; Bailey Wayne; Caedmon Cazares; Zachary Lorbiecki; Carly Scroggins; Elianna Duo; Matthew Short; Santiago Sanchez; Rylee Richardson; Bryson Weaver; Isabel Sellers; Dalton ONeill; Aubrey Schaefer; Bridget Vazquez; Kolten Wells; Nicholas Brown; Desire De Los Santos; Ava Holladay; Raegen Stringer; Hector Jimenez Gil; Aileen Vasquez Munoz; Tanner Chilton; Kamryn Edenburn; Gabriel Pound; Jay Saunders; McKayla Schendel; Breanna Weller; Addison Ray; Aidan Ward; Sophia Wozencraft; Anna Wood; Olivia Hosley; Gillian Rice; Kate Thomas; Riley FitzGerald; Tyler Gumm; Grant Siuts; Nathan Bleecher; Kaylin Owen; and Thayden Root.


    Juniors

    High Honors: Avery Alagna; Noah Bryant; Elle Cheely; Madelyn Darnall; Ashlyn Denney; Kade Dubson; Chloey Duitsman; Ava Fenter; Catharine Ford; Kadence Goff; Sophia Hartke; Dallas Hollingsworth; Wyatt Huffstutler; Alex Mowrer; Camryn Reedy; Rylee Reifsteck; Lydia Rossi; Savannah Rubin; Lauren Shaw; Daniel Stein; Avery Watson; Ashely Rennels; Jenna Adkins; Lindy Bates; Paige Brewer; Faith Hall; Lauren Hellmer; Ryan Rink; Josephine Cler; Emily Decker; Maegan Rothe; Estella Dodd; and Molly Baxley.

    Honor Roll: Joseph Tempel; Oscar Boldt; Gracie Meharry; Gavin Weaver; Sophia Beckett; Paige Garretson; McKenzie Hart; Nolan Wishall; Jordan Daugherty; Logan Church; Hunter Eastin; Tessah Williams; Austin Mikeworth; Logan Zumbahlen; Bentten Cain; Franke Davis; Sophia Frye; Andrew King; Brady Parr; McKinley Weller; Lindsey Johnson; Sydney Jackson; and Nathaniel DeNeal.


    Sophomores

    High Honors: Anna Amias; Mylie Castle; Eli Crowe; Ella Darnall; Crewe Eckstein; Callie Ellars; Camden Fairbanks; Margaret Garcier; Collin Graven; Isabel Grob; Faith Lampe; Kallista Lancaster; Mylie Loftsgaard; Claire Meharry; Harry Polonus; Dallas Porter; Mackenzie Pound; Ty Rodems; Katie Ruggieri; Vanna Schriefer; Hunter Shike; Annalise Shunk; Caden Stierwalt; Ginna Stierwalt; Madelyn Stierwalt; Emma Swisher; Carter Tiemann; Anna Vasey; Lucille Wiesbrook; Paula Wilson; Lucas Hood; Deakin Moore; Isaac Neverman; Olivia Egelston; Olivia Rawdin; Claire Zorns; Kaylee Cooke; Caden Hensch; Logan Jeurissen; Bailey Tompkins; Savanna Cruz; Chason Daly; and Kenley Harris.

    Honor Roll: Chloe Cousins; Samantha Gumbel; Ian Taber; Phoenix Molina; Mason ONeill; Shelby Smith; Aria Battaglia; Maddix Buchanan; Jillian Schlittler; Andrew Ray; Dane Eisenmenger; Anna Kuhns; Analea Popovics; Shelby Zoch; Brayden Henry; Tyler Henry; Desmond Winfrey; Johanna Langley, Ethan Mohr; Heath Stringer; Cameron Kaiser; Brody Osterbur; Kyla Reed; Kamden Schuckman; Olivia Tempel; Bryan Crosby; Abram Davidson; Tanner Gallivan; and Joshua Heath.


    Freshmen

    High Honors: Dominic Baxley; Clare Bryant; Caleb Coy; Lillian Daly; Hudson DeHart; Danika Eisenmenger; Allison Fenter; Journey Gabbard; Bailee Gadeken; Colton Harmon; Avery Kamradt; Kathryn Knoll; Audrey McDaniel; Emily Osterbur; Adam Reedy; Allyson Shaw; Evalyn Skibbe; Piper Staley; Grace Tempel; Jacob Ward; Leah Watson; Maggie Weckle; Grace Wherley; Rylan Wolf; Broderick Irwin; Cash McCann; Elizabeth Wayne; Grace Bickers; Max Rossi; Alex Bromley; Berkley Cloud; Lucy Kleiss; Cadence Chandler; Reese Frye, Brooklyn Mumm; Kendal Zerrusen; and Aidan Ellis.

    Honor Roll: Addison Davis; Olivia Hall; Madison Spohn; Paige Bradley; Braedyn Dalton; Taylor Finley; Landrey Mohr; Addison Wyatt; Alyssa Shields; Isaac Siegwald; Ethan Schaefer; Nicole Paeth; Evan Puckett; Juan Acosta Toro; Noah Conde; Sadie Polonus; Ava Wolf Rice; Natalie Haas; Nicholas Montgomery; Elizabeth Farney; and Rush Little.


    Red Dress Collection Concert kicks off American Heart Month

    by The American Heart Association

    DALLAS – Powerful players in music, entertainment, fashion and philanthropy joined the American Heart Association, the world’s leading nonprofit organization focused on heart and brain health for all, to celebrate progress towards health equity, while calling for a renewed commitment to investing in women’s heart health in a fashion-forward, musical kickoff to American Heart Month.

    The Red Dress Collection® Concert—hosted this year from the Appel Room at Jazz at Lincoln Center in New York City—serves as the American Heart Association’s Go Red for Women national marquee event. Every year, it builds on the iconic tradition of the Red Dress Collection fashion show founded by the National Heart, Lung, and Blood Institute’s The Heart Truth® program, adding musical performances and personal stories of those affected by heart disease and stroke. This year, the event kicks off both American Heart Month, commemorated every February, as well as the Association’s centennial celebration, marking 100 years of service saving and improving lives, and positioning the Association as a change agent for generations to come.

    Host Sherri Shepherd wore Ganni on the red carpet and Harbison on the runway. The Daytime Emmy Award-winning talk show host, comedian, actress, and best-selling author began the event by sharing her own connection with cardiovascular disease and spotlighting survivors and women’s health champions in attendance, before introducing the evening’s opening entertainment, GRAMMY-nominated country music star, Mickey Guyton.

    The country trailblazer wore Sergio Hudson on the red carpet and Monetre on the runway. Wearing custom RC Caylan for her performance, she opened with “My Side of Country,” and performed hits “Something About You,” “Make It Me,” and “Flowers.”

    This year’s concert was headlined by Award-winning musician, actor, advocate and New York Times best-selling author Demi Lovato. The Grammy-nominated artist was introduced on stage by Damar Hamlin, cardiac arrest survivor, Buffalo Bills safety and American Heart Association national ambassador for the Nation of Lifesavers™. The 25-year-old experienced his sudden cardiac arrest on the NFL football field last year and now uses his platform to raise awareness of the need for CPR and AEDs.

    Lovato wore a Nicole + Felicia Couture custom gown on the red carpet, and performed wearing a custom Michael Ngo suit. The set started with Lovato singing chart-topper, “Confident,” and continued with hits “Give Your Heart a Break,” “Tell Me You Love Me,” “Sorry Not Sorry,” “Anyone,” “Neon Lights,” “No Promises,” “Skyscraper,” “Heart Attack,” and closed the evening with “Cool for the Summer” alongside all of the Red Dress Collection Concert participants.

    Holding true to the Red Dress Collection’s origin in fashion, red haute couture moments were served throughout the show, reclaiming the power of sisterhood and community against the No. 1 killer of women, cardiovascular disease.

    Other stars of stage and screen lending their support to the event included: Ana Navarro-Cárdenas (Co-host of ABC’s The View and CNN political commentator) wearing Alexander by Daymor, Bellamy Young (actor, singer and producer; Scandal) wearing Gustavo Cadile on the red carpet and Sachin & Babi on the runway, Brandi Rhodes (Pro wrestling star and founder of Naked Mind Yoga + Pilates) wearing Do Long, Brianne Howey (actress and mother, Ginny & Georgia) wearing Reem Acra, Dominique Jackson (model, actress, author and star of FX's Pose) wearing Coral Castillo, Francia Raísa (actress & entrepreneur) wearing Goddess Exclusive on the red carpet and Maria Lucia Hohan on the runway, Heather Dubrow (actress, author, podcast host and TV personality on Real Housewives of OC) wearing Gattinolli by Marwan on the red carpet and Pamella Roland on the runway, Katherine McNamara (award winning actor, singer, writer, and producer) wearing Mikael D, Madison Marsh (Active Duty Air Force Officer - Second Lieutenant and Miss America 2024) wearing Jovani, Mira Sorvino (Academy Award-winning actress and human rights advocate, Shining Vale and Romy and Michele’s High School Reunion) wearing Dolce and Gabbana, Richa Moorjani (actress and activist, star of Netflix’s Never Have I Ever) wearing Oscar de la Renta, Samira Wiley (Emmy winner for The Handmaid's Tale and producer) wearing Le Thanh Hoa, and Yvonne Orji (actress, comedienne, author; known for the TV show Insecure) wearing House of Emil on the red carpet and Jovana Louis on the runway.

    As part of its commitment to supporting women and women's health, KISS USA is proud to support the American Heart Association’s Go Red for Women movement, and the Red Dress Collection Concert.

    The Go Red for Women movement, sponsored nationally by CVS Health, exists to increase women’s heart health awareness, and serves as a catalyst for change in the drive to improve the lives of all women. Find resources to support women’s heart health at every age, through every stage of life at GoRedforWomen.org


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