Depression and Antidepressant Use After Stroke and Transient Ischemic Attack
Background and Purpose—Patients with stroke and transient ischemic attack (TIA) often have comparable comorbidities, but it is unclear whether they have similar rates of depression or antidepressant use.
Methods—This study was a secondary analysis of a prospective cohort registry that enrolled subjects from 2006 to 2008 in the United States. Depression (defined by the Patient Health Questionnaire-8 score ≥10) and medication use were prospectively assessed 3 and 12 months after hospitalization in 1450 subjects with ischemic stroke and 397 subjects with TIA.
Results—The proportional frequency of depression after stroke and TIA was similar at 3 months (17.9% versus 14.3%, P=0.09) and at 12 months (16.4% versus 12.8%, P=0.08). The rates of newly identified depression between 3 and 12 months were also similar (8.7% versus 6.2%, P=0.12). Persistent depression (defined as Patient Health Questionnaire-8 score ≥10 at both 3 and 12 months) was present in 134 (9.2%) of those with stroke and in 30 (7.6%) of those with TIA. Younger age, greater stroke-related disability, and inability to work at 3 months were associated with persistent depression in subjects with stroke. Among subjects with persistent depression, 67.9% of those with stroke and 70.0% of those with TIA were not using antidepressants at either time point (P=0.920).
Conclusions—Stroke and TIA subjects had a similar frequency of depression at 3 and 12 months after hospitalization and similar rates of newly identified depression between 3 and 12 months. A high proportion of those with persistent depression was untreated.