Prevention of Poststroke Depression: Does Prophylactic Pharmacotherapy Work?

“…96 Pooled analyses revealed that the likelihood of developing PSD was reduced among patients receiving active pharmacological treatment (OR, 0.34; 95% CI, 0.22-0.53), especially after a 1 year treatment (OR, 0.31; 95% CI, 0.18-0.56), and with the use of an SSRI (OR, 0.37; 95% CI, 0.22-0.61). The most commonly reported side effects were nausea, diarrhea, fatigue, and dizziness.…”

Section: Prevention Of Psd Using Pharmacological Interventionsmentioning

confidence: 96%

“…Only tremor was significantly associated with sertraline in 1 of the RCTs. 96 This review included 2 publications from the same cohort and an open trial (drug vs usual care). These review results are contrary to an earlier 2008 Cochrane systematic review including 12 placebo-controlled trials of 611 individuals, finding no evidence that antidepressant drugs prevented depression after stroke.…”

Section: Prevention Of Psd Using Pharmacological Interventionsmentioning

confidence: 99%

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Towfighi¹,

Ovbiagele²,

Husseini³

et al. 2017

Stroke

533

506

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Abstract-Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion. This multispecialty statement provides a comprehensive review of the current evidence and gaps in current knowledge of the epidemiology, pathophysiology, outcomes, management, and prevention of PSD, and provides implications for clinical practice. (Stroke. 2017;48:e30-e43.

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“…230 A subsequent literature review that used some overlapping studies also concluded that selective serotonin reuptake inhibitors may reduce the odds for developing poststroke depression. 231 Lastly, treatment of chronic pain or other physical symptoms, as described in previous sections, may also result in improvement in concomitant depressive symptoms.…”

Section: Poststroke Depressionmentioning

confidence: 99%

Palliative and End-of-Life Care in Stroke

Holloway¹,

Arnold²,

Creutzfeldt³

et al. 2014

Stroke

243

120

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Background and Purpose-The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association's framework for defining classes and level of evidence and recommendations. Results-The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient-and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in continuous quality improvement and research. Conclusions-Addressing the palliative care needs of patients and families throughout the course of illness can complement

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Prevention of Poststroke Depression: Does Prophylactic Pharmacotherapy Work?

Cited by 81 publications

References 47 publications

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Palliative and End-of-Life Care in Stroke

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