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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0786

Comparative effectiveness of fluoxetine and bupropion in post-stroke depression: findings from the TriNetX Research Network

COMPARATIVE EFFECTIVENESS OF FLUOXETINE AND BUPROPION FOR POST-STROKE DEPRESSION: INSIGHTS FROM THE TRINETX RESEARCH NETWORK

In post-stroke depression, bupropion was associated with a lower risk of suicidal ideation than fluoxetine, but with a higher risk of demoralization and apathy.

The study aimed to compare the effects of selective serotonin reuptake inhibitor (SSRI) and norepinephrine–dopamine reuptake inhibitor (NDRI) treatments on the frequency of suicidal ideation in post-stroke depression (PSD). A retrospective cohort study covering the period from 2005 to 2025 was conducted using the TriNetX Research Network database. Patients over 18 years of age who were diagnosed with PSD within one year of a stroke and started on bupropion (cohort 1) or fluoxetine (cohort 2) were examined. Propensity score matching was used to balance baseline demographic characteristics and comorbidities, and a total of 108,664 patients were included, with 53,917 patients in each cohort; the groups were similar in terms of age, sex, race, and ethnicity (p-values were largely above 0.05). The primary outcome was suicidal ideation, and the secondary outcomes were apathy and demoralization; odds ratios (ORs) were calculated with 95% confidence intervals (CIs). The risk of suicidal ideation was significantly lower in patients taking bupropion than in those taking fluoxetine (OR 0.762; 95% CI 0.704 to 0.825; p=0.000); the recurrence rate was reported as 2.04% for bupropion and 2.66% for fluoxetine. Conversely, the risk of demoralization and apathy was significantly higher with bupropion (OR 1.544; 95% CI 1.065 to 2.238; p=0.021); the corresponding rates were 0.13% for bupropion and 0.08% for fluoxetine. The authors state that these findings demonstrate the differing psychiatric effects of antidepressant classes and support individualized treatment selection in the management of PSD.

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