Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Administration of SSRIs may improve gross motor function, reduce disability and enhance QOL for patients recovering from stroke.

Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos

“…Psychotropic medication use suggests the presence of anxiety, depression, and/or psychotic disorders serious enough to warrant pharmacological intervention. These conditions, and at times the medications used to treat them (Barker, Greenwood, Jackson, & Crowe, 2004;Yeo, Lim, Mao, & Yau, 2017), may negatively impact cognition. Including these conditions and/or individuals using such medications in our analyses would confound our interpretation of results within the conceptual framework of lipid levels and cognition.…”

Anticholinergic and Sedative Drug Burden and Functional Recovery after Cerebrovascular Accident: A Retrospective Descriptive Study

“…Patients transferred from acute stroke care facilities to convalescent hospitals are in the sub-acute stage of cerebrovascular accidents, and their higher brain function is in the process of recovery. Because early treatment with selective serotonin reuptake inhibitors could be beneficial for the recovery of FIM in patients with post-stroke depression, 36 , 37 ) the effectiveness of anticholinergic and sedative drugs might outweigh the risk of any negative effects on cognitive function during this period.…”

How effective is current pharmacotherapy for motor recovery after stroke?

“…Strategies aimed at inducing brain plasticity and modulating brain activity in order to achieve functional goals are essential as well. Despite post-stroke cures and cares made great strides, there is no clear evidence on the role of pharmacological treatment in post-stroke recovery [6][7][8][9][10][11][12]. Drugs specifically aimed at acting onto neuroplasticity-based recovery mechanisms may indeed have a significant role in this field.…”

“…The neurotransmitter cascade mediating anti-inflammatory effects, angiogenesis, neurogenesis, and axon and dendritic re-growth may represent an interesting target for post-stroke drugs, taking into account that recovery mostly occurs within the first 3 months following stroke [12]. Specifically, these drugs (including antidepressants, e.g., SSRI, glutamate antagonists, cholinomimetics, e.g., cholinesterase inhibitors, amphetamines, and dopamine agonists, amphetamines and monoamine oxidase inhibitors) can increase motor cortex excitability, as well as LTP-like plasticity magnitude and duration [12]. However, the currently available data show either positive or lacking effects on motor and cognitive improvement in post-stroke individuals [12,13].…”

“…Specifically, these drugs (including antidepressants, e.g., SSRI, glutamate antagonists, cholinomimetics, e.g., cholinesterase inhibitors, amphetamines, and dopamine agonists, amphetamines and monoamine oxidase inhibitors) can increase motor cortex excitability, as well as LTP-like plasticity magnitude and duration [12]. However, the currently available data show either positive or lacking effects on motor and cognitive improvement in post-stroke individuals [12,13]. In particular, it has been shown that 100 mg LDopa/day significantly boosted motor recovery, also influencing several different non-motor neural systems (including motivation and reward ones), in addition to physical therapy [13].…”