Depression and Antidepressant Use After Stroke and Transient Ischemic Attack

Abstract

Background and Purpose-Patients with stroke and transient ischemic attack (TIA) often have comparable comorbidities, but it is unclear whether they have similar rates of depression or antidepressant use. Methods-This study was a secondary analysis of a prospective cohort registry that enrolled subjects from 2006 to 2008 in the United States. Depression (defined by the Patient Health Questionnaire-8 score Ն10) and medication use were prospectively assessed 3 and 12 months after hospitalization in 1450 subjects with ischemic stroke and 397 subjects with TIA. Results-The proportional frequency of depression after stroke and TIA was similar at 3 months (17.9% versus 14.3%, Pϭ0.09) and at 12 months (16.4% versus 12.8%, Pϭ0.08). The rates of newly identified depression between 3 and 12 months were also similar (8.7% versus 6.2%, Pϭ0.12). Persistent depression (defined as Patient Health Questionnaire-8 score Ն10 at both 3 and 12 months) was present in 134 (9.2%) of those with stroke and in 30 (7.6%) of those with TIA.Younger age, greater stroke-related disability, and inability to work at 3 months were associated with persistent depression in subjects with stroke. Among subjects with persistent depression, 67.9% of those with stroke and 70.0% of those with TIA were not using antidepressants at either time point (Pϭ0.920). Conclusions-Stroke and TIA subjects had a similar frequency of depression at 3 and 12 months after hospitalization and similar rates of newly identified depression between 3 and 12 months. A high proportion of those with persistent depression was untreated. (Stroke. 2012;43:1609-1616.)

Post-stroke depression

“…A PSD-t gyakran nem ismerik fel, ezért kezelése elmarad [10], pedig az irodalomban számos utalást találha-tunk rá, hogy a depresszív irányú hangulatzavar meghosszabbítja a kórházi akut ellátás időtartamát [11], rontja a beteg rehabilitációját, funkcionális felépülését [12,13], napi aktivitását [14], életminőségét [15] és nö-veli a stroke utáni mortalitást [15,16,17]. Ezenkívül a depresszív irányú hangulatváltozás negatív hatással van a párkapcsolatra [14] és növeli egy újabb stroke kockázatát [18].…”

Mental health: Ups and downs

“…A year on, El Husseini found, those with transient ischaemic attacks were just as likely to be depressed as those with full blown strokes 7 . Apparently, there is something about how strokes affect the brain that triggers depression.…”

CASE-REPORT Dysregulation of gene expression in a patient with depressive disorder after transient ischemic attack confirmed by a neurophysiological neuromarker

“…Three months following hospitalization for stroke or TIA, 17.9% of stroke patients had depression compared to 14.3% of TIA patients; at 12 months, the percentages were 16.4 and 12.8%, respectively (El Husseini et al, 2012). Persistent depression (diagnosis of depression at both 3 and 12 months) was present in 9.2% of those with stroke and 7.6% of those with TIA.…”

“…The post-stroke depression is both frequent in patients with established stroke (Rao, 2000;Hackett et al, 2005;Haq et al, 2010;Wu et al, 2010;Luijendijk et al, 2011;Eskes et al, 2015;Swartz et al, 2016) and minor stroke or transient ischemic attack (TIA) (Luijendijk et al, 2011;El Husseini et al, 2012;Carnes-Vendrell et al, 2016;Maaijwee et al, 2016).…”

“…Recent studies reveals that patients with stroke or TIA, a "warning stroke" not usually associated with long-lasting functional deficit, have similar frequency of depression and newly identified depression between 3 and 12 months after hospitalization (House et al, 2001;Watkins et al, 2011;El Husseini et al, 2012;Tene et al, 2016).…”