Antidepressants and the Risk of Ischemic Stroke in Older Adults According to the Degree of Serotonin Reuptake Inhibition: A Retrospective Cohort Study

•What is the primary question addressed by this study?Is there any association between ischemic stroke and antidepressant use in older adults according to the degree of serotonin reuptake inhibition?•What is the main finding of this study?The risk of ischemic stroke was 1.192- and 1.057-fold higher in strong and intermediate serotonin reuptake inhibitor (SRI) users than in weak SRI users. The risk was increased especially in high-dose antidepressants even for short-duration use.•What is the meaning of the finding?Intermediate and strong SRIs should be considered more cautiously because of the risk of ischemic stroke in older adult patients. For patients who are exposed to intermediate and strong SRIs of more than 1 defined daily dose or use other concomitant drugs, extra precaution must be taken even for a short duration.