Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study

Kim, Jong Sung; Lee, Eun‐Jae; Chang, Dae-Il; Park, Jong-Ho; Ahn, Seong Hwan; Cha, Jae‐Kwan; Heo, Ji Hoe; Sohn, Sung Il; Lee, Byung‐Chul; Kim, Dong‐Eog; Kim, Hahn Young; Kim, Seongheon; Kwon, Do Hoon; Kim, Jei; Seo, Woo‐Keun; Lee, Jun; Park, Sang-Won; Koh, Seong‐Ho; Kim, Jin Young; Choi-Kwon, Smi

doi:10.1016/s2215-0366(16)30417-5

Cited by 97 publications

(72 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to the results of the EMOTION study,19 escitalopram treatment was not associated with significant improvement in neurological and cognitive function during the study period.…”

Section: Resultssupporting

confidence: 81%

“…Patients were enrolled from 17 university hospitals throughout South Korea. Details about the EMOTION study design and results have been published elsewhere 19. Briefly, patients older than 20 years with acute stroke (within 21 days of onset) were enrolled.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we conducted a randomised controlled trial, efficacy of escitalopram on poststroke emotional disturbances and neurological dysfunction (EMOTION),19 which explored the efficacy of early administration of escitalopram on poststroke emotional disturbances and neurological deficits in >400 patients with stroke. In this trial, we investigated polymorphisms of SERT gene in the participants who had provided additional consents on the genetic tests.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use

Lee

Kim

et al. 2017

J Neurol Neurosurg Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similar to the results of the EMOTION study,19 escitalopram treatment was not associated with significant improvement in neurological and cognitive function during the study period.…”

Section: Resultssupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use

Lee

Kim

et al. 2017

J Neurol Neurosurg Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…No significant differences were detected in response to escitalopram according to 5-HTTLPR genotype [9,17]. The EMOTION study only included the 5-HT-TLPR polymorphism, and not the rs25531 single nucleotide polymorphism, which might have led to categorizing the functionally low expression L G allele as high expression [12].…”

Section: Discussionmentioning

confidence: 99%

Serotonergic Regulation and Cognition after Stroke: The Role of Antidepressant Treatment and Genetic Variation

et al. 2019

View full text Add to dashboard Cite

Introduction: Serotonin affects several brain functions including cognition. The serotonin transporter (SERT) regulates brain serotonin levels through reuptake into neurons. The gene encoding this transporter, the SERT gene, has several functional polymorphisms affecting the number of transporters and thereby the serotonin levels. SERT gene expression may be important for cognition and selective serotonin reuptake inhibitors (SSRI) may improve cognition post stroke. We therefore examined the association between SERT genotypes, cognitive function and early treatment with the SSRI citalopram among non-depressed Caucasian stroke patients. Patients and Methods: SERT gene polymorphisms in 270 non-depressed first-ever acute ischemic stroke patients randomized to citalopram, n = 130, or placebo, n = 140, were investigated. Patients were genotyped for a length polymorphism (L = long and S = short allele) and a single nucleotide polymorphism (A/G substitution) dividing the L-allele into L_A and L_G. According to these genotypes, patients were further grouped according to low (S/S, L_G/S and L_G/L_G), medium (S/L_A and L_G/L_A), or high functional gene expression (L_AL_A). Cognition was measured by the Symbol Digit Modalities Test (SDMT) at 1 and 6 months. Mean SDMT scores according to genotype and randomization groups were compared using multiple logistic regression adjusting for age, stroke severity, premorbid functional status, and vascular risk factors including smoking, hypertension, and diabetes. Results: Stratified by genotype groups, there were no statistically significant differences in SDMT scores between randomization groups. Placebo-treated patients with low SERT expression genotypes, however, tended to have lower mean SDMT scores (at 1 month: 30.2, SD 10.8) compared to citalopram-treated patients (33.6, SD 13.7). Within the placebo group, the low genotype expression patients had significantly lower adjusted mean SDMT scores at 1 month compared to the high genotype expression patients (adjusted mean difference of –6 points, CI –12.0 to –0.05). We found similar results at 6 months, although not statistically significant. The genotype expression was not associated with SDMT scores among citalopram-treated patients. Conclusion: There was no difference in cognition between citalopram and placebo-treated patients according to the genotype group. Our results indicate, however, that low expression SERT genotype may contribute to reduced cognitive function post stroke as placebo-treated patients with low SERT expression tended to score lower on the SDMT. The significant difference in SDMT scores between low and high expression patients was present only in the placebo-treated group, thereby warranting further exploration of the potential effect of early citalopram treatment on cognitive functioning. Our results are preliminary and need replication in larger-scale studies.

show abstract

“…Hackett и соавт., Американская ассоциация по проблемам сердца/Американская ассоциация по лечению инсульта выпустили рекомендации, в которых отметили эффективность антидепрессантов при постинсультной депрессии [57,63,64]. К препаратам первой линии относятся селективные ингибиторы обратного захвата серотонина, поскольку они лучше переносятся пожилыми пациентами [65]. При недостаточном эффекте селективных ингибиторов обратно-го захвата серотонина рекомендуется переходить к антидепрессантам других групп: трициклическим антидепрессантам, ингибиторам обратного захвата серотонина и норадреналина и др.…”

Section: терапия постинсультных аффективных нарушенийunclassified

Anxiety-Depressive Disorders in Patients After Stroke: Prevalence, Approaches to Diagnosis and Therapy

Gogoleva¹,

Vv²

2019

EPh

View full text Add to dashboard Cite

Evident anxiety-depressive disorders are being observed in at least one third of patients who have suffered a stroke. They significantly reduce the effectiveness of rehabilitation measures and secondary prevention that is why they require drug and non-drug correction. Anxiety-depressive disorders after a stroke can be caused by a psychological reaction to the disease, damage to the certain areas of the brain, primarily the anterior localization, and exacerbation of pre-stroke mental illness. In the rehabilitation period of stroke in the treatment of anxiety-depressive disorders apart from the classic antidepressants and tranquilizers are proven themselves well neurometabolic drugs with additional positive thymoleptic and anxiolytic effect.

show abstract

Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study

Cited by 97 publications

References 27 publications

Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use

Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use

Serotonergic Regulation and Cognition after Stroke: The Role of Antidepressant Treatment and Genetic Variation

Anxiety-Depressive Disorders in Patients After Stroke: Prevalence, Approaches to Diagnosis and Therapy

Contact Info

Product

Resources

About