Wishing to die or self-harm after stroke: A planned secondary analysis of the AFFINITY Randomised Controlled Trial

•Stroke is associated with increased risk of depression and of suicidal ideation and acts.•It is unclear if the routine use of antidepressants after a stroke decreases the cumulative prevalence of suicidal ideation.•This randomised controlled trial showed that the cumulative prevalence of recurrent wish to die or self-harm affected 2.5 % and 3.7 % of participants treated with placebo and fluoxetine, respectively, after 52 weeks of follow-up.•Routine daily treatment with fluoxetine for 26 weeks neither increases nor decreases the cumulative prevalence of suicidal/death ideation after 26 and 52 weeks.