Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery

Legg, Lynn; Rudberg, Ann‐Sofie; Hua, Xing; Wu, Simiao; Hackett, Maree L.; Tilney, Russel; Lindgren, Linnea; Кутлубаев, М А; Hsieh, Ching‐Hua; Barugh, Amanda; Hankey, Graeme J.; Lundström, Erik; Dennis, Martin; Mead, Gillian

doi:10.1002/14651858.cd009286.pub4

Cited by 43 publications

(33 citation statements)

References 97 publications

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“…Despite theoretical beneficial effects of serotonin on promoting neural plasticity and the initial enthusiasm about using serotonergic treatment (fluoxetine) to improve recovery after stroke, recent randomized controlled trials have failed to show an overall benefit of serotonergic treatment on stroke recovery. 10 These trials adopted a generalized approach whereby patients received fluoxetine therapy irrespective of their serotonergic status. Perhaps a more personalized approach based on serotonergic status would have improved the success rate of such trials.…”

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confidence: 99%

Cholinergic neurotransmitter system: a potential marker for post-stroke cognitive recovery

Geranmayeh

2022

Brain

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Cholinergic neurotransmitter system: a potential marker for post-stroke cognitive recovery

Geranmayeh

2022

Brain

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“…SSRIs are anti-inflammatory agents and enhance neurogenesis through the upregulation of neurotrophins, possibly supported by the stimulation of mitochondrial energy metabolism ( 3 ). However, their long-term use is limited due to adverse effects such as bleeding and intracerebral hemorrhage ( 15 ). Therefore, it is necessary to explore more effective drugs.…”

Section: Discussionmentioning

confidence: 99%

“…A large cohort study suggested that all commonly used antidepressants can contribute to significantly increased risks of adverse outcomes, including mortality, suicide, hemorrhagic complications, falls, and upper gastrointestinal bleeding (12)(13)(14). High-quality evidence suggests that SSRIs increased the risk of bone fractures and possibly the risk of seizures (15). Therefore, other treatment options need to be explored.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Chinese herbal medicine on poststroke depression in animal models: A systematic review and meta-analysis

Huo

Wang

et al. 2023

Front. Neurol.

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BackgroundPoststroke depression (PSD) is a common complication that can seriously affect patients' functional recovery and quality of life after a stroke. Various side effects have been found to be associated with the pharmacological therapies used for PSD. Studies have shown that Chinese herbal medicine (CHM) can effectively improve PSD-like behavior and neurological function in clinical and animal studies. The efficacy of CHM on PSD in animal models has not been systematically analyzed.MethodsThe following electronic databases were searched for articles published up to September 2022: PubMed, Web of Science, the Cochrane Library, and Embase. Studies that reported the efficacy of CHM in animals with PSD and were written in English were included. Depression-like behavior and the neurological deficit score were assessed as measures of efficacy. The included studies assessed depression-like behavior using sucrose preference, open-field, forced swimming, and tail suspension tests, as well as body weight. The Review Manager version 5.4 and STATA version 13.1 software packages were used for the meta-analysis. The standardized mean difference (SMD) with 95% confidence intervals was used to assess all the outcomes. Subgroup analyses were performed to explore the sources of heterogeneity. The Egger's test and funnel plots were used to assess the potential publication bias. Sensitivity analyses were used to identify the stability of the results.ResultsA total of 14 studies, including 12 CHMs involving 442 rats, fulfilled the inclusion criteria for meta-analysis. The pooled results showed that CHM significantly alleviated neurological deficits (−1.72 SMD, −2.47– −0.97) and was efficacious in improving the depression-like behavior of rats in the sucrose preference (2.08 SMD, 1.33–2.84), open-field (2.85 SMD, 1.88–3.83), forced swimming (−1.83 SMD, −2.23−1.44), and tail suspension tests (−1.35 SMD, −1.94−0.76).ConclusionOur results suggest that CHM could significantly improve depression-like behavior and neurological function in animals with PSD. The current results should be interpreted with caution because only animal studies were included.

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“…Systematic reviews of dopamine agonists 143 and selective serotonin reuptake inhibitors 144–146 show no consistent beneficial effects on cognition after stroke. Individual small clinical trials have reported various pharmaceutical agents that may have a potential benefit on global cognition: neurotrophics (Cortexin), 147 peptides such as Cerebrolysin 148 and relaxin, 149 citicoline (cytidine-5′-diphosphocholine), 150 and nitrates (glyceryl trinitrate).…”

Section: Management Of Pscimentioning

confidence: 99%

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

Husseini¹,

Katzan²,

Rost³

et al. 2023

Stroke

110

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Purpose: Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. Methods: We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. Results: PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management.

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Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery

Cited by 43 publications

References 97 publications

Cholinergic neurotransmitter system: a potential marker for post-stroke cognitive recovery

Cholinergic neurotransmitter system: a potential marker for post-stroke cognitive recovery

Efficacy of Chinese herbal medicine on poststroke depression in animal models: A systematic review and meta-analysis

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

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