Post-Stroke Depression: Mechanisms and Pharmacological Treatment

Publication date: Available online 9 November 2017 Source:Pharmacology & Therapeutics Author(s): Roberto Federico Villa, Federica Ferrari, Antonio Moretti Depression, the most frequent psychiatric disorder following ischaemic stroke, negatively affects survivals' functional outcome, response to rehabilitation and quality of life. Approximately, one-third of them are affected by post-stroke depression (PSD), making it a serious social and public health problem and anti-depressant preventive and curative therapies worth investigating. However, a two-way association between depression and stroke has been also established: stroke increases the risk of PSD, but depression is an independent risk factor for stroke. The pathophysiology of PSD is presumably multifactorial, involving a combination of various ischaemia-induced neurobiological dysfunctions in the context of psychosocial distress. The damage of frontal-basal ganglia brainstem pathway suggested alterations of monoaminergic neurotransmitter systems. Several lines of evidence point to a relationship between neuroinflammatory response to acute ischaemic stroke, stress activation of the hypothalamic-pituitary-adrenal (HPA) axis and the impairment of adaptative response (neurogenesis) within a background of altered energy metabolism (i.e. mitochondrial dysfunction). The complexity of PSD mechanisms makes its biologically-based prevention and treatment a difficult task. So far, especially the selective serotonin (5-...
Source: Pharmacology and Therapeutics - Category: Drugs & Pharmacology Source Type: research