Benefits of antidepressant treatment after a stroke

Abstract

IntroductionStroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.MethodThe databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.ResultsAntidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.ConclusionAntidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Thrombolytic therapy in ischemic stroke patients with a preceding transient ischemic attack in telestroke and non‐telestroke settings

“…13 Patients treated with antidepressants are known to present with better recovery from disability when compared with patients who did not receive antidepressant therapy. 29 This is because antidepressant drugs enhance functional recovery in post-stroke depression (PSD) patients. 6,20 In PSD patients with ischemic stroke that present with moderate to severe motor deficits, treatment with antidepressants combined with rtPA enhanced motor recovery.…”

“…6,20 In PSD patients with ischemic stroke that present with moderate to severe motor deficits, treatment with antidepressants combined with rtPA enhanced motor recovery. 29 Moreover, use of antidepressants is known to be effective in preventing depression after stroke and is without significant adverse effects in ischemic stroke patients treated with rtPA. 17 These findings support our current result indicating that inclusion of TIA-ischemic population with antidepressant therapy in non-depressed stroke patients for rtPA therapy may reduce the odds for development of PSD and improve functional recovery.…”

“…Patients treated with antidepressants are known to present with better recovery from disability when compared with patients who did not receive antidepressant therapy 29 . This is because antidepressant drugs enhance functional recovery in post‐stroke depression (PSD) patients 6,20 .…”

“…This is because antidepressant drugs enhance functional recovery in post‐stroke depression (PSD) patients 6,20 . In PSD patients with ischemic stroke that present with moderate to severe motor deficits, treatment with antidepressants combined with rtPA enhanced motor recovery 29 . Moreover, use of antidepressants is known to be effective in preventing depression after stroke and is without significant adverse effects in ischemic stroke patients treated with rtPA 17 .…”

Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind–Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology

“…Conversely, CVD affects mental health, especially in women. Compared to men, women experience twice the prevalence of major depressive disorder (MDD) after stroke [ 42 ]. After myocardial infarction, young women are twice as likely to develop mental stress-induced myocardial ischemia as men of the same age [ 43 ].…”