Document Type

Conference Proceeding

Publication Date

5-1-2026

Abstract

Background: Cerebrovascular Accident (CVA), or stroke, is the fourth highest cause of death and the leading cause of disability in the United States. Although used typically as antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs) have been linked to positive outcomes in stroke recovery. This retrospective chart review evaluated differences in motor recovery with prior versus de novo Selective Serotonin Reuptake Inhibitor use in the inpatient rehabilitation setting. Methods: Participant data were obtained using a convenience sample of adult (aged 18 or older) ischemic stroke patients admitted to the inpatient rehabilitation unit at a suburban inpatient rehabilitation unit from January 1, 2016, through December 31, 2017. Functional Independence Measure (FIM) scores, a standardized assessment used for rehabilitation progress, was used to assess differences in motor recovery. Chi-squared and ANOVA analyses were used to examine group differences on FIM scores between the stroke groups (de novo SSRI vs. post-stroke SSRI vs. no SSRI). Results: The analysis included a total of 324 participants; 115 participants with post-stroke SSRI use, 29 participants with de novo SSRI use, and 180 participants with no SSRI use. Demographic characteristics, race/ethnicity, t-PA use, and most medical comorbidities did not differ significantly across groups (p > 0.05). Significant group differences were observed for discharge disposition, length of stay (LOS), admission motor function, and prevalence of mental and behavioral disorders. Discharge disposition varied by group (p = 0.013), with post-stroke and pre-stroke participants more frequently discharged to skilled nursing facilities. LOS differed significantly (p < 0.001), with the post-stroke group demonstrating a longer mean LOS (16.7 ± 6.4 days) compared to the no SSRI group (12.0 ± 5.5 days) and the pre-stroke group (13.6 ± 6.0 days). Admission total motor FIM scores were significantly lower in the post-stroke group compared to the no SSRI group (p = 0.040). Comorbidity of mental and behavioral disorders were significantly more prevalent in the pre-stroke (79.3%) and post-stroke (60.0%) groups compared to the no SSRI group (45.0%) (p < 0.001). No significant differences were observed in discharge FIM scores (total, motor, or cognition) across groups. Conclusion: In this cohort, timing of SSRI use was associated with meaningful differences in rehabilitation course. A history of the comorbidity of mental and behavioral disorders is a risk factor for affecting motor performance and rehabilitation. Participants who needed a SSRI in a rehabilitation setting have a longer length of stay compared to patients who were previously on an SSRI or required no SSRI. These findings underscore the importance of integrating behavioral health support in stroke-related rehabilitation planning.

Comments

American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter 2026 Resident and Medical Student Day, May 1, 2026, Troy, MI

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