Ida Kim Wium-Andersen1, Marie Kim Wium-Andersen1, Martin Balslev Jørgensen1, Merete Osler1. 1. From the Psychiatric Center Ballerup, Ballerup, Denmark (I. Wium-Andersen); the Research Center for Prevention and Health, Glostrup Hospital, Glostrup, Denmark (I. Wium-Andersen, M. Wium-Andersen, Osler); the Psychiatric Center Frederiksberg, Frederiksberg, Denmark (M. Wium-Andersen); the Psychiatric Center Copenhagen, Department O, and Institute of Clinical medicine University of Copenhagen, Denmark (I. Wium-Andersen, K. Wium-Andersen, Jørgensen); and the Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark (Osler).
Abstract
BACKGROUND: Depression is a common complication after stroke, and inflammation may be a pathophysiological mechanism. This study examines whether anti-inflammatory treatment with acetylsalicylic acid (ASA), nonsteroid anti-inflammatory drugs (NSAIDs) or statins influence the risk of depression after stroke. METHODS: A register-based cohort including all patients admitted to hospital with a first-time stroke from Jan. 1, 2001, through Dec. 31, 2011, and a nonstroke population with a similar age and sex distribution was followed for depression until Dec. 31, 2014. Depression was defined as having a hospital contact with depression or having filled prescriptions for antidepressant medication. The associations between redeemed prescriptions of ASA, NSAIDs or statins with early- (≤ 1 year after stroke or study entry) and late-onset (> 1 year after stroke or study entry) depression were analyzed using Cox proportional hazard regression. RESULTS: We identified 147 487 patients with first-time stroke and 160 235 individuals without stroke for inclusion in our study. Redeemed prescriptions of ASA, NSAIDs or statins after stroke decreased the risk for early-onset depression, especially in patients with ischemic or severe stroke. Patients who received a combination of anti-inflammatory treatments had the lowest risk for early-onset depression. On the other hand, use of ASA or NSAIDs 1 year after stroke increased the risk for late-onset depression, whereas statin use was associated with a tendency toward a decreased risk. LIMITATIONS: The study used prescription of antidepressant medication as a proxy measure for depression and did not include anti-inflammatory drugs bought over the counter. CONCLUSION: Anti-inflammatory treatment is associated with a lower risk for depression shortly after stroke but a higher risk for late depression. This suggests that inflammation contributes differently to the development of depression after stroke depending on the time of onset.
BACKGROUND:Depression is a common complication after stroke, and inflammation may be a pathophysiological mechanism. This study examines whether anti-inflammatory treatment with acetylsalicylic acid (ASA), nonsteroid anti-inflammatory drugs (NSAIDs) or statins influence the risk of depression after stroke. METHODS: A register-based cohort including all patients admitted to hospital with a first-time stroke from Jan. 1, 2001, through Dec. 31, 2011, and a nonstroke population with a similar age and sex distribution was followed for depression until Dec. 31, 2014. Depression was defined as having a hospital contact with depression or having filled prescriptions for antidepressant medication. The associations between redeemed prescriptions of ASA, NSAIDs or statins with early- (≤ 1 year after stroke or study entry) and late-onset (> 1 year after stroke or study entry) depression were analyzed using Cox proportional hazard regression. RESULTS: We identified 147 487 patients with first-time stroke and 160 235 individuals without stroke for inclusion in our study. Redeemed prescriptions of ASA, NSAIDs or statins after stroke decreased the risk for early-onset depression, especially in patients with ischemic or severe stroke. Patients who received a combination of anti-inflammatory treatments had the lowest risk for early-onset depression. On the other hand, use of ASA or NSAIDs 1 year after stroke increased the risk for late-onset depression, whereas statin use was associated with a tendency toward a decreased risk. LIMITATIONS: The study used prescription of antidepressant medication as a proxy measure for depression and did not include anti-inflammatory drugs bought over the counter. CONCLUSION: Anti-inflammatory treatment is associated with a lower risk for depression shortly after stroke but a higher risk for late depression. This suggests that inflammation contributes differently to the development of depression after stroke depending on the time of onset.
Authors: Corline Brouwers; Stefan B Christensen; Nikki L Damen; Johan Denollet; Christian Torp-Pedersen; Gunnar H Gislason; Susanne S Pedersen Journal: Int J Cardiol Date: 2015-11-06 Impact factor: 4.164
Authors: N Müller; M J Schwarz; S Dehning; A Douhe; A Cerovecki; B Goldstein-Müller; I Spellmann; G Hetzel; K Maino; N Kleindienst; H-J Möller; V Arolt; M Riedel Journal: Mol Psychiatry Date: 2006-02-21 Impact factor: 15.992
Authors: Terese S H Jørgensen; Ida K Wium-Andersen; Marie K Wium-Andersen; Martin B Jørgensen; Eva Prescott; Solvej Maartensson; Per Kragh-Andersen; Merete Osler Journal: JAMA Psychiatry Date: 2016-10-01 Impact factor: 21.596
Authors: Morten Schmidt; Sigrun Alba Johannesdottir Schmidt; Jakob Lynge Sandegaard; Vera Ehrenstein; Lars Pedersen; Henrik Toft Sørensen Journal: Clin Epidemiol Date: 2015-11-17 Impact factor: 4.790
Authors: Lana J Williams; Julie A Pasco; Mohammadreza Mohebbi; Felice N Jacka; Amanda L Stuart; Kamalesh Venugopal; Adrienne O'Neil; Michael Berk Journal: Int J Neuropsychopharmacol Date: 2016-02-02 Impact factor: 5.176
Authors: Kejia Hu; Arvid Sjölander; Donghao Lu; Adam K Walker; Erica K Sloan; Katja Fall; Unnur Valdimarsdóttir; Per Hall; Karin E Smedby; Fang Fang Journal: BMC Med Date: 2020-09-09 Impact factor: 8.775