Selective Serotonin Reuptake Inhibitors and Poststroke Epilepsy: A Population-Based Nationwide Study

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• 作者：Chien-Chen Chou ; MD^a ; ^b ; Der-Jen Yen ; MD^a ; ^b ; Yung-Yang Lin ; MD ; PhD^a ; ^c ; ^d ; Yu-Chiao Wang ; MSc^e ; ^g ; Cheng-Li Lin ; MSc^e ; ^g ; Chia-Hung Kao ; MD^f ; ^h ; ⁱ ; ^{d10040@mail.cmuh.org.tw}
• 关键词：aHR ; adjusted hazard ratio ; DDD ; defined daily dose ; HR ; hazard ratio ; ICD-9-CM ; International Classification of Diseases ; Ninth Revision ; Clinical Modification ; IQR ; interquartile range ; LHID2000 ; Longitudinal Health Insurance Database 2000 ; NHI ; National Health Insurance ; NHIRD ; National Health Insurance Research Database ; PY ; person-year ; SSRI ; selective serotonin reuptake inhibitor
• 刊名：Mayo Clinic Proceedings
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：92
• 期：2
• 页码：193-199
• 全文大小：329 K
• 卷排序：92

文摘

To investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on poststroke epilepsy in a population-based nationwide study.Patients and MethodsThe SSRI group included patients who received a stroke diagnosis from January 1, 2000, through December 31, 2009, and were prescribed SSRIs after stroke. The non-SSRI group enrolled patients with stroke who were not prescribed SSRIs from the Taiwan National Health Insurance Research Database and used propensity score matching based on the index year, duration time, sex, age, type of stroke, and duration of hospitalization. Cox proportional hazards models were used to estimate the risk of epilepsy between the SSRI and comparison groups.ResultsA total of 4688 patients with stroke (2344 in each of the SSRI and non-SSRI cohorts) were enrolled. The cumulative incidence of epilepsy in the SSRI group was significantly higher than that in the comparison group (log-rank P<.001). In the SSRI group, the risk of poststroke epilepsy increased 2.45-fold (95% CI, 1.69- to 3.57-fold) compared with that in the comparison group. Furthermore, the risk of poststroke epilepsy increased with the defined daily dose of SSRIs. For patients with ischemic stroke, SSRIs users had a 2.74-fold higher risk of epilepsy than non users (95% CI, 1.79- to 4.22-fold).ConclusionIn this study, SSRI users had a higher risk of poststroke epilepsy than nonusers. Further study is warranted to investigate the causal relationship between SSRI exposure and poststroke epilepsy.