Side-Effects of Nortriptyline Treatment for Post-Stroke Depression

Fullerton, Andrew; Agerholm, Margaret

doi:10.1016/s0140-6736(84)92894-0

Cited by 17 publications

(5 citation statements)

References 3 publications

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“…This suggests that milnacipran is an effective treatment of PSD which does not interfere with the improvement of ADL recovery. Although the efficacy of TCA and SSRI in PSD has been shown, cardiovascular and gastrointestinal side‐effects have been reported 6,7 . Milnacipran has been reported to have the same antidepressant efficacy as TCA with fewer physical side‐effects such as gastrointestinal symptoms as compared with SSRI 2 .…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of selective serotonin reuptake inhibitors (SSRI) in PSD has also recently been reported 5,6 . However, TCA and SSRI have an adverse influence on ADL caused by side‐effects and interactions with other drugs 4,7 . The ideal antidepressant for PSD should be devoid of interactions with other drugs because stroke patients are often given numerous drugs including antihypertensive and anticoagulant drugs.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Yamakawa

Satoh

Sawa

et al. 2005

Psychiatry Clin Neurosci

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Post-stroke depression (PSD) has a negative impact on rehabilitation following stroke. No satisfactory antidepressant treatment for PSD has yet been developed. The present study examined the effect of milnacipran, a serotonin and norepinephrine reuptake inhibitor, on PSD patients. Eleven PSD patients taking milnacipran in a rehabilitation hospital were compared to age-matched, sex-matched, and severity of depression at admission-matched PSD patients hospitalized during 2001 who did not take any antidepressant as historical control. Severity of depression was measured using self-rating depression scale for depression (SDS) assessed at admission and discharge after 3 months inpatient rehabilitation. Activities of daily living (ADL) and quality of life (QOL) were measured, respectively, by the functional independence measure (FIM) and a self-completed questionnaire for QOL (QUIK) as outcomes of rehabilitation. For the SDS score, the group taking milnacipran showed significant improvement compared to the control group in our study. FIM was improved in both groups. In the end QUIK did not change significantly in either group. We found no major side-effects of milnacipran among the patients. These results suggest that milnacipran is a safe and effective treatment for PSD for inpatients undergoing rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Yamakawa

Satoh

Sawa

et al. 2005

Psychiatry Clin Neurosci

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“…One study ( 1 1 ) found that patients treated with nortriptyline showed greater improvement than a control group treated with placebo. Warnings about the treatment of this vulnerable group of patients have been made (12,13).…”

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confidence: 99%

Depression among patients with stroke

Dam

Pedersen

Ahlgren

1989

Acta Psychiatr Scand

118

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Ninety-two stroke patients and 30 control patients participated in this study. Stroke patients showed a higher frequency of depression than controls. Stroke patients with the lesion in the right hemisphere were more depressed than patients with the lesion in the left hemisphere. No correlation was found between the degree of depression and the degree of impaired physical function, degree of aphasia or volume of lesion.

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“…For example, fluoxetine inhibits P450 enzyme and interacts with cardiac medications [95]. Nortriptyline also interacts with cardiac medications and may cause delirium [96].…”

Section: Reviewmentioning

confidence: 99%

“…A Cochrane review by Fullerton, et al found that antidepressants did not show any evidence to prevent post-stroke depression [96]. However, psychotherapy significantly prevented depression and improved mood.…”

Section: Reviewmentioning

confidence: 99%

Post Stroke Depression Frequently Overlooked, Undiagnosed, Untreated

Dar¹,

Venigalla²,

Khan³

et al. 2017

Neuropsychiatry

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Depression is the most frequently seen neuropsychiatric manifestation in stroke patients. It hampers the ability to undergo therapy and impairs their functional outcome. Depression also increases the risk of suicide in stroke patients, therefore, increasing mortality. The etiology of post-stroke depression (PSD) is complex and reported to be multi-factorial in origin. It also depends on the size and location of the infarct. In addition, family history or prior history of depressive disorders makes them prone to be affected with depression following a stroke. In this article, we will mention various aspects of PSD, as well as the prevalence and the different screening assessment tools used in literature studies. Although there are many available testing tools, little consistency was seen in them being valid or reliable. We will also discuss the pathophysiology of depression in stroke patients with various available options for managing the condition. We will briefly review the use of alternative treatment such as Electroconvulsive therapy (ECT) and Transcranial Magnetic Stimulation (TMS) as well. However, we need further evidence-based research exploring the screening tool; i.e. universally acceptable for PSD and implementing an effective, non-invasive treatment modality impacting the prognosis. Also, we require further investigations to identify the role of antidepressants in the recovery of stroke patients. Keywords:Stroke, Post-stroke depression, Stroke location, Assessment and Treatment, Post-stroke Depression, Prevalence of PSD, Pathology in PSD, Mood disorders in PSD, Symptoms and diagnosis criteria in PSD, Assessment scales in PSD, Pharmacotherapy and other treatments in PSD, Depression in stroke survivors MethodologyA search for relevant published literature was performed using PubMed, Google Scholar. The keywords and phrases used included: Stroke lesion, post stroke depression, major depression, Post stroke symptoms, assessment and treatment. Other relevant studies were found by a review of the primary studies obtained in the search as well as reference tracing of selected articles. The inclusion and exclusion criteria were: Any articles that reported the symptomatology, pathophysiology, evaluation and treatment of post stroke depression. All research studies which were published in English language from Neuropsychiatry (London) (2017) 7(6) 907 Review Ali Mahmood Khan PrevalenceOn average for every 40 seconds, there is a stroke case in the United States -around 600.000 new stroke cases are evident every year [12,13]. Based on the literature studies, there is variability in data reported about PSD prevalence. These differences are usually due to the variations in criteria used to diagnose PSD and the difference in age of patients studied. The higher prevalence was seen in hospital-based settings rather than community-based settings [14].While several clinicians use DSM-III and DSM-IV criteria to reach the diagnosis of PSD, some use a different kind of scales or questionnaires. Also, different clin...

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Side-Effects of Nortriptyline Treatment for Post-Stroke Depression

Cited by 17 publications

References 3 publications

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Depression among patients with stroke

Post Stroke Depression Frequently Overlooked, Undiagnosed, Untreated

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