Podcast: Selective serotonin reuptake inhibitors for stroke recovery

Stroke is a major cause of death and disability across the world, with many reviews from the Cochrane Stroke Group providing evidence on the effects of treatments and rehabilitation interventions. In November 2019, the Group published their update of their review of selective serotonin reuptake inhibitors and we asked lead author, Gillian Mead from the University of Edinburgh in Scotland, to tell us more.Stroke is a common cause of disability in the community. Although there have been major advances in the care of stroke patients over the last few years, many survivors are still left with physical disability, such as weakness down one side of the body, called hemiparesis, difficulty speaking, low mood, anxiety, fatigue, and memory and thinking problems. Therefore, we need better treatments to address stroke disability.One possibility is the group of drugs called selective serotonin reuptake inhibitors (or SSRI for short). These have been used for many years to treat mood disorders in the general population and also after stroke. In 2011, a French trial showed that one of the SSRI, fluoxetine, improved recovery of arm weakness if given early after stroke, in people without mood problems.   We then performed a Cochrane review of all trials of SSRI given after stroke and found that SSRIs did seem to reduce disability. However, we could not be confident that the results were reliable, because many of the studies were small and had multiple sources of bias. On the positive si...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news

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This study aimed to address these questions.MethodsThis study included 219 patients with acute ischemic stroke consecutively admitted to a regional hospital in Hong Kong. BDES was defined as a Chinese version of the Dysexecutive Questionnaire (DEX) score of ≥20 assessed at three months after stroke. The HRQoL was assessed with the Chinese version of the Stroke-Specific Quality of Life (SSQoL) questionnaire encompassing 12 domains. Multivariate linear regression models were employed to examine the association between BDES symptoms and the SSQoL total and domain scores. Structural equation model (SEM) was further construc...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
CONCLUSIONS: Participation improves in the first 12 months after stroke and stabilizes afterwards. Mood problems and less adaptive psychological factors negatively influence the course of participation over time up to four years after stroke. Implications for rehabilitation Follow-up assessments after stroke should not only focus on cognitive and motor impairment, but also encompass screening on mood problems and adaptive psychological factors. Implementation of a routine follow-up assessment one year after stroke can be beneficial as restrictions in participation are unlikely to diminish spontaneously from then onw...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Authors: Zauszniewski JA, Herbell K, Lekhak N, Badr H Abstract Given the growing number of family members who provide care to adults with a disability or illness, this study examined differences in coping resources and mental health among family caregivers of persons with various health conditions. Within the context of Ensel and Lin's stress paradigm, 234 family caregivers participated in an online study by completing validated measures of resourcefulness, spiritual practices, caregiver burden, anxiety, and depression. Caregivers were categorized into nine groups according to their care recipient's condition. The ...
Source: Issues in Mental Health Nursing - Category: Nursing Tags: Issues Ment Health Nurs Source Type: research
Conclusion: This is the first Indian study demonstrating depression in patients with CVST and use of SA-SIP to assess quality of life in them. Occurrence of depression in CVST is as high as in arterial strokes.
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research
CONCLUSION: This is the first study indicating an association between sTREM-1 and PSD. Our results may point to the involvement of glial mechanisms in the manifestation of depressive symptoms after stroke. PMID: 32819258 [PubMed - as supplied by publisher]
Source: Current Neurovascular Research - Category: Neurology Authors: Tags: Curr Neurovasc Res Source Type: research
Brain stroke is the most common cause of permanent disability worldwide and has a serious negative impact on the lives of patients and their families.1,2 Due to the unexpected and sudden occurrence of stroke, the family members of the patients inflicted with this condition are confronted with adverse consequences. Accordingly, they should adapt themselves to this condition and its associated complications. Moreover, they should play the role of a caregiver, which causes shock, anxiety, and depression in the patient family.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
If health professionals are to involve major stroke patients and their families in making decisions about treatments, they need to describe prognosis in terms that are easily understood. We suggest that referring to “specific abilities”, such as ability to be independent, walk, talk, eat normally, be continent, live without severe pain, live without major anxiety or depression and to live at home may be more easily understood than terms such as disabled based on the modified Rankin scale (mRs).
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Conclusions: Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as pre-stroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services.IMPLICATIONS FOR REHABILITATIONThe stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clin...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
AbstractTo describe sexual functioning/satisfaction and relational satisfaction of patients with stroke who received sexual counselling during their rehabilitation 1 –5 years thereafter. All adult patients with stroke admitted to one Dutch Rehabilitation Centre between January 2010 and January 2014 with at least two consultations with a sexologist were invited to participate in this cross-sectional survey study. Patients were asked to complete a questionnaire on sexual functioning, relational satisfaction (Maudsley Marital Questionnaire, 0–80; low–high dissatisfaction), health-related quality of life...
Source: Sexuality and Disability - Category: Disability Source Type: research
Abstract Stroke remains a leading cause of disability in the United States. Despite recent advances, interventions to reduce damage and enhance recovery after stroke are lacking. P2X4R, a receptor for adenosine triphosphate (ATP), regulates activation of myeloid immune cells (infiltrating monocytes/macrophages and brain-resident microglia) after stroke injury. However, over-stimulation of P2X4Rs due to excessive ATP release from dying or damaged neuronal cells can contribute to ischemic injury. Therefore, we pharmacologically inhibited P2X4R to limit the over-stimulated myeloid cell immune response and improve bot...
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
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