Role of functional pharmacological therapy in post-stroke depression: a narrative review

Corallo, Francesco; Scarfì, Chiara; Arcadi, Francesca Antonia; Formica, Caterina; Cara, Marcella Di; Palmeri, Rosanna; Romeo, Laura; Buono, Viviana Lo; Bramantı, Placido; Marıno, Silvia; Cola, Maria Cristina De

doi:10.1177/0300060520950557

Cited by 8 publications

(11 citation statements)

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“…Choline and betaine are essential nutrients for humans, and our findings have further demonstrated that plasma choline and betaine could offer additional predictive value for PSD, suggesting that choline and betaine may be potential biomarkers for depression after ischemic stroke. Existing evidence suggested that choline and betaine could be used as supportive therapies or adjunct drugs for depression [34,35]. It is of great interest to test the effect of supplementation with choline and betaine on depression in patients with acute ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Circulating choline pathway nutrients and depression after ischemic stroke

Miao

Che

et al. 2021

Euro J of Neurology

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Background and purpose Choline pathway nutrients, including choline and betaine, are reported to exert antidepressant effects. However, there is little population‐based evidence on the relationships between circulating choline and betaine and poststroke depression (PSD). We aimed to prospectively explore the associations between plasma choline and betaine and depression after ischemic stroke. Methods This study was based on the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 612 participants with plasma choline and betaine concentrations were included in the analysis. The study outcome was depression 3 months after ischemic stroke. Logistic regression models were performed to estimate the relationships between plasma choline and betaine and the risk of PSD. Risk reclassification and calibration of models with choline or betaine were analyzed. Results Patients with PSD had lower choline and betaine levels than those without PSD (p < 0.05). Compared with tertile 1, the multivariable‐adjusted odds ratios (95% CIs) for tertile 3 of choline and betaine were 0.54 (0.35–0.83) and 0.59 (0.38–0.92), respectively. Per 1 SD increase in choline or betaine was associated with a 25% (95% CI 9%–37%) or an 19% (95% CI 3%–32%) decreased risk of PSD, respectively. Furthermore, the addition of choline or betaine to the established risk factors model improved the risk reclassification for PSD, as shown by an increase in the net reclassification index and integrated discrimination improvement (all p < 0.05). Conclusions Patients with elevated levels of choline and betaine had a lower risk of depression after acute ischemic stroke, suggesting the protective significance of choline pathway nutrients for PSD.

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Section: Discussionmentioning

confidence: 99%

Circulating choline pathway nutrients and depression after ischemic stroke

Miao

Che

et al. 2021

Euro J of Neurology

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Section: Introductionmentioning

confidence: 99%

“… 16 Indeed, drugs such as citicoline or choline alphoscerate could be used for the treatment of mood disorders in post-ischaemic stroke patients, as supportive drugs to the antidepressant treatment or as an alternative therapy in mild symptomatology. 16 …”

Section: Introductionmentioning

confidence: 99%

“…15 Most research supports the efficacy of these antidepressants, 13 but very few studies have evaluated the efficacy of other pharmacological therapies, such as psychostimulants. 16 Indeed, drugs such as citicoline or choline alphoscerate could be used for the treatment of mood disorders in postischaemic stroke patients, as supportive drugs to the antidepressant treatment or as an alternative therapy in mild symptomatology. 16 The aim of this study was to investigate whether a therapy based on nootropic drugs could be at least as effective in the reduction of anxiety and depressive symptoms as an antidepressant therapy in patients with PSD.…”

Section: Introductionmentioning

confidence: 99%

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Role of citicoline and choline in the treatment of post-stroke depression: an exploratory study

et al. 2021

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Objective To compare selective serotonin reuptake inhibitors (SSRIs) and nootropic drugs in the reduction of anxiety and depressive symptoms in post-stroke patients. Methods This retrospective cohort study included patients diagnosed with post-stroke depression that were treated with either SSRIs or nootropic drugs (i.e. citicoline or choline alphoscerate). Depression and anxiety were assessed using the Hamilton Rating Scales. Statistical associations between the use of nootropic drugs and mood disorder improvements were determined by measuring assessment scores at 6-months. Results A total of 44 post-stroke patients with depression (aged 45–75 years) were enrolled in the study: 20 were treated with SSRIs and 24 received nootropic drugs. From baseline to follow-up, the SSRI group showed a large effect size with regard depression (success rate difference [SRD] 0.57; 95% confidence interval [CI] 0.21, 0.79) and anxiety (SRD 0.49; 95% CI 0.14, 0.74), whereas the nootropic group showed a small effect size for depression (SRD 0.16; 95% CI –0.17, 0.46) and a small effect size for anxiety (SRD 0.36; 95% CI –0.03, 0.62). Conclusion The administration of nootropic drugs could be a valid therapeutic strategy to manage post-stroke patients suffering from mild–moderate anxiety or anxious-depressive syndrome, but this requires further research.

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“…Because their side effects are often well tolerated, SSRIs are considered the treatment of first choice. SSRIs play a role in complicated signaling pathways that lead to enhanced neurogenesis, which activates axonal buds and encourages the formation of new synapses 8,9. In a recent study, patients on SSRIs had a decreased incidence of PSD and a substantial improvement in motor performance when compared to placebo controls.…”

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confidence: 99%

The Role of Pharmacological Therapy and Psychotherapy in Post Stroke Depression

Ratnasari

2021

SciPsy

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The most prevalent emotional illness following a stroke is post-stroke depression. Some of the symptoms of post-stroke depression include loss of interest, decreased energy, decreased appetite, problems sleeping, self-blame, and even suicide thoughts. To overcome the symptoms of post-stroke depression requires comprehensive management. In the PSD population, antidepressant medication has demonstrated to be effective. In order to obtain comprehensive health services, rehabilitation activities are also required as one of the therapies in the psychological sector of patients with post-stroke depression.

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Role of functional pharmacological therapy in post-stroke depression: a narrative review

Cited by 8 publications

References 43 publications

Circulating choline pathway nutrients and depression after ischemic stroke

Circulating choline pathway nutrients and depression after ischemic stroke

Role of citicoline and choline in the treatment of post-stroke depression: an exploratory study

The Role of Pharmacological Therapy and Psychotherapy in Post Stroke Depression

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