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Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery
CONCLUSIONS: There is high-quality evidence that SSRIs do not make a difference to disability or independence after stroke compared to placebo or usual care, reduced the risk of future depression, increased bone fractures and probably increased seizure risk.PMID:34780067 | DOI:10.1002/14651858.CD009286.pub4
Source: Cochrane Database of Systematic Reviews - November 15, 2021 Category: General Medicine Authors: Lynn A Legg Ann-Sofie Rudberg Xing Hua Simiao Wu Maree L Hackett Russel Tilney Linnea Lindgren Mansur A Kutlubaev Cheng-Fang Hsieh Amanda J Barugh Graeme J Hankey Erik Lundstr öm Martin Dennis Gillian E Mead Source Type: research

Poststroke Selective Serotonin Reuptake Inhibitors
In the community, major risk factors for depression include sex, advancing age, lower income, employment status, and illnesses such as stroke that result in disability and affect income, employment, and social status. Poststroke depression affects 1 in every 3 patients in the first year after stroke occurrence and thereafter. Important general treatments for depression include the selective serotonin reuptake inhibitors; these compounds have also been suggested to modulate motor and functional recovery after stroke. The FLAME (Fluoxetine for Motor Recovery After Acute Ischaemic Stroke) trial kindled interest in treatment w...
Source: JAMA Neurology - August 2, 2021 Category: Neurology Source Type: research

Fluoxetine for Stroke: A Mixed Bag of Outcomes
J Clin Psychiatry. 2021 Jun 8;82(3):21f14106. doi: 10.4088/JCP.21f14106.ABSTRACTStroke is the leading neurologic cause of burden operationalized in terms of disability-adjusted life-years. After stroke, motor deficits, cognitive deficits, and depression cause loss of independence, disability, decreased functioning, and reduced quality of life; these persist into the long term. There are theoretical grounds to consider that, through neuroplasticity and other mechanisms, such impairments can be prevented or attenuated by the early introduction of a selective serotonin reuptake inhibitor such as fluoxetine. However, a recent ...
Source: Journal of Clinical Psychiatry - June 9, 2021 Category: Psychiatry Authors: Chittaranjan Andrade Source Type: research

Does the Initiation of Fluoxetine Postacute Stroke Result in Improved Functional Recovery?: A Critically Appraised Topic
Conclusion: Among patients with stroke, early initiation of fluoxetine did not result in improved functional recovery. Lower rates of depression were observed in the fluoxetine-treated group; however these patients experienced higher rates of bone fracture.
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Critically Appraised Topics Source Type: research

Prevention of depression in adults with long-term physical conditions
CONCLUSIONS: Based on evidence of very low certainty, our results may indicate the benefit of pharmacological interventions, during or directly after preventive treatment. Few trials examined short-term outcomes up to six months, nor the follow-up effects at six to 12 months, with studies suffering from great numbers of drop-outs and inconclusive results. Generalisation of results is limited as study populations and treatment regimes were very heterogeneous. Based on the results of this review, we conclude that for adults with long-term physical conditions, there is only very uncertain evidence regarding the implementation...
Source: Cochrane Database of Systematic Reviews - March 5, 2021 Category: General Medicine Authors: Hanna Kampling Harald Baumeister J ürgen Bengel Oskar Mittag Source Type: research

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 weakn...
Source: Cochrane News and Events - February 26, 2020 Category: Information Technology Authors: Lydia Parsonson Source Type: news

Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.
CONCLUSIONS: We found no reliable evidence that SSRIs should be used routinely to promote recovery after stroke. Meta-analysis of the trials at low risk of bias indicate that SSRIs do not improve recovery from stroke. We identified potential improvements in disability only in the analyses which included trials at high risk of bias. A further meta-analysis of large ongoing trials will be required to determine the generalisability of these findings. PMID: 31769878 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 25, 2019 Category: General Medicine Authors: Legg LA, Tilney R, Hsieh CF, Wu S, Lundström E, Rudberg AS, Kutlubaev MA, Dennis M, Soleimani B, Barugh A, Hackett ML, Hankey GJ, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Treatments for Poststroke Motor Deficits and Mood Disorders: A Systematic Review for the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Guidelines for Stroke Rehabilitation.
Conclusion: Cardiorespiratory training, repetitive task training, and transcranial direct current stimulation may improve ADLs in adults with stroke. Cognitive behavioral therapy, exercise, and SSRIs may reduce symptoms of poststroke depression, but use of SSRIs to prevent depression or improve motor function was not supported. Primary Funding Source: U.S. Department of Veterans Affairs, Veterans Health Administration. PMID: 31739315 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - November 18, 2019 Category: Internal Medicine Authors: D'Anci KE, Uhl S, Oristaglio J, Sullivan N, Tsou AY Tags: Ann Intern Med Source Type: research

Pharmacological interventions and rehabilitation approach for enhancing brain self-repair and stroke recovery.
Abstract Neuroplasticity is a natural process occurring in the brain for entire life. Stroke is the leading cause of long term disability and huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies targets chronic stage. Recovery after stroke depends on the ability of our brain to reestablish structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are ...
Source: Current Neuropharmacology - July 24, 2019 Category: Drugs & Pharmacology Authors: Szelenberger R, Kostka J, Saluk-Bijak J, Miller E Tags: Curr Neuropharmacol Source Type: research

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