Effect of the Early Administration of Selective Serotonin Reuptake Inhibitors on the Time Course of Poststroke Fatigue: A 2-Year Longitudinal Study

Jinjing Wang; Fang Wang; Mengmeng Gu; Lulu Xiao; Pengfei Xu; Jianglong Guo; Shiyi Jiang; Yujing Liu; Yuanlu Liu; Wen Sun; Xinfeng Liu

doi:10.3389/fneur.2021.748473

Effect of the Early Administration of Selective Serotonin Reuptake Inhibitors on the Time Course of Poststroke Fatigue: A 2-Year Longitudinal Study

Front Neurol. 2022 Jan 20:12:748473. doi: 10.3389/fneur.2021.748473. eCollection 2021.

Authors

Jinjing Wang¹, Fang Wang¹, Mengmeng Gu², Lulu Xiao¹, Pengfei Xu³, Jianglong Guo³, Shiyi Jiang³, Yujing Liu⁴, Yuanlu Liu⁵, Wen Sun³, Xinfeng Liu^{1

3}

Affiliations

¹ Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
² Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
³ Division of Life Sciences and Medicine, Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
⁴ Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, China.
⁵ Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China.

Abstract

Background: Poststroke fatigue (PSF) is a dynamic process over time. Current evidence for interventions for PSF is limited. Our study investigated the effects of selective serotonin reuptake inhibitors (SSRIs) on the time course of PSF.

Methods: The patients with acute ischaemic stroke were enrolled in this study. All patients were scored with the Fatigue Severity Scale (FSS) at baseline and 6, 12, and 24 months after the index stroke. The time course of PSF was classified as non-PSF, incident PSF, recovered PSF and persistent PSF according to the PSF status at baseline and the 24-month follow-up. Multivariate logistic regression analysis and generalized mixed model were applied to explore the relationships between SSRIs and the time course of PSF.

Results: Eight hundred forty-seven patients were analyzed in this study. No significant association between SSRIs and the time course of PSF was observed in all patients (p = 0.076). The subgroup analyses indicated that SSRI antidepressants reduced the risk of incident PSF [Odds Ratio (OR) 0.23; 95% confidence interval (CI) 0.05-0.96, p = 0.044] and persistent PSF (OR 0.28; 95% CI 0.09-0.90, p = 0.033) in the PSD subgroup, but not in the non-PSD group. In the longitudinal analysis, generalized logistical mixed-effect models indicated that early administration of SSRIs reduced the risk (OR 0.955; 95% CI 0.928-0.984, p = 0.002) and severity (β = -0.018, p = 0.041) of PSF in the PSD subgroup.

Conclusion: No relationship was identified between the use of SSRIs and the time course of PSF in all patients. However, these drugs might be effective in PSF patients with depression.

Keywords: antidepressant; depression; poststroke fatigue; time course; treatment.