Adult females with clinical depression are 29% more likely to suffer a stroke than other women of the same age without depression, according to an article published in the journal Stroke. The authors, from Harvard Medical School added that there is a 39% higher risk for those on SSRIs (selective serotonin reuptake inhibitors). Examples of SSRIs include Prozac, Celexa and Zoloft.

The investigators performed a six-year follow-up in the Nurses’ Health Study, which included 80,574 females aged from 54 to 79 years. The study spanned from 2000 to 2006. None of the women had a history of stroke.

Dr. Kathryn Rexrode, a senior author, explained that the usage of anti-depressant medications could be an indication of the severity of depression.

Rexrode wrote:

“I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

The investigators assessed depressive symptoms on various occasions. They used a Mental Health Index. Starting in 1996, patient anti-depressant usage was reported every two years. Physician diagnosed depression reporting began in 2000.

For this study, depression was defined as either being currently diagnosed with the disorder or having a history of depression.

At baseline, 22% of those studied had depression. There were 1,033 cases of stroke during the six-year follow-up.

The authors wrote that women with depression were more likely to be less physically active, they had a higher BMI (body mass index), single, younger and regular smokers, compared to other women (without depression or a history of it).

A higher-than average number of women also had coexisting conditions, such as heart disease, diabetes and high blood pressure (hypertension).

Rexrode wrote:

“Depression can prevent individuals from controlling other medical problems, such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise. All these factors could contribute to increased risk.”

Senior author An Pan PhD said that several mechanisms may be involved in raising the risk of stroke, including an underlying vascular disease in the brain, or inflammation.

An Pan stated:

“Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise. We cannot infer cause or fully exclude the possibility that the results could be explained by other unmeasured unknown factors. Although the underlying mechanisms remain unclear, recognizing that depressed women may be at a higher risk of stroke merits additional research into preventive strategies in this group.”

The researchers concluded:

” Our results suggest that depression is associated with a

moderately increased risk of subsequent stroke.”

Written by Christian Nordqvist