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Pharmaceutical interventions for emotionalism after stroke
CONCLUSIONS: Antidepressants may reduce the frequency and severity of crying or laughing episodes when compared to placebo, based on very low-certainty evidence. Our conclusions must be qualified by several methodological deficiencies in the trials and interpreted with caution despite the effect being very large. The effect does not seem specific to one drug or class of drugs. More reliable data are required before appropriate conclusions can be made about the treatment of post-stroke emotionalism. Future trialists investigating the effect of antidepressants in people with emotionalism after stroke should consider developi...
Source: Cochrane Database of Systematic Reviews - November 17, 2022 Category: General Medicine Authors: Sabine Allida Allan House Maree L Hackett Source Type: research

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

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

Update to the FOCUS, AFFINITY and EFFECTS trials studying the effect(s) of fluoxetine in patients with a recent stroke: statistical analysis plan for the trials and for the individual patient data meta-analysis
Three large trials of fluoxetine for stroke recovery (FOCUS (fluoxetine or control under supervision), AFFINITY (the Assessment oF FluoxetINe In sTroke recovery) and EFFECTS (Efficacy oF Fluoxetine —a randomisE...
Source: Trials - November 25, 2020 Category: General Medicine Authors: Gillian Elizabeth Mead, Catriona Graham, Laurent Billot, Per N äsman, Erik Lundström, Steff Lewis, Graeme J. Hankey, Maree L. Hackett, John Forbes and Martin Dennis Tags: Update Source Type: research

Correction to: Update on the EFFECTS study of fluoxetine for stroke recovery: a randomised controlled trial in Sweden
Following publication of the original article [1], we were notified that one of the corresponding author ’s affiliations was omitted.
Source: Trials - May 7, 2020 Category: General Medicine Authors: Erik Lundstr öm, Eva Isaksson, Per Näsman, Per Wester, Björn Mårtensson, Bo Norrving, Håkan Wallén, Jörgen Borg, Martin Dennis, Gillian Mead, Graeme J. Hankey, Maree L. Hackett and Katharina S. Sunnerhagen Tags: Correction Source Type: research

Update on the EFFECTS study of fluoxetine for stroke recovery: a randomised controlled trial in Sweden
Studies have suggested that fluoxetine might improve neurological recovery after stroke, but the results remain inconclusive. The EFFECTS (Efficacy oF Fluoxetine – a randomisEd Controlled Trial in Stroke) reac...
Source: Trials - February 28, 2020 Category: General Medicine Authors: Erik Lundstr öm, Eva Isaksson, Per Näsman, Per Wester, Björn Mårtensson, Bo Norrving, Håkan Wallén, Jörgen Borg, Martin Dennis, Gillian Mead, Graeme J. Hankey, Maree L. Hackett and Katharina S. Sunnerhagen Tags: Update Source Type: research

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

Fluoxetine and recovery after stroke
Publication date: Available online 5 December 2018Source: The LancetAuthor(s): H Bart van der Worp
Source: The Lancet - December 5, 2018 Category: General Medicine Source Type: research

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial
Publication date: Available online 5 December 2018Source: The LancetAuthor(s): Martin Dennis, Gillian Mead, John Forbes, Catriona Graham, Maree Hackett, Graeme J Hankey, Allan House, Stephanie Lewis, Erik Lundström, Peter Sandercock, Karen Innes, Carol Williams, Jonathan Drever, Aileen Mcgrath, Ann Deary, Ruth Fraser, Rosemary Anderson, Pauli Walker, David Perry, Connor McgillSummaryBackgroundResults of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.MethodsFOCUS was a pragmatic, multicentre, parallel group, double-b...
Source: The Lancet - December 5, 2018 Category: General Medicine Source Type: research

The FOCUS, AFFINITY and EFFECTS trials studying the effect(s) of fluoxetine in patients with a recent stroke: a study protocol for three multicentre randomised controlled trials
DiscussionIf fluoxetine is safe and effective in promoting functional recovery, it could be rapidly, widely and affordably implemented in routine clinical practice and reduce the burden of disability due to stroke.Trial registrationFOCUS: ISRCTN83290762 (23/05/2012), AFFINITY: ACTRN12611000774921 (22/07/2011). EFFECTS: ISRCTN13020412 (19/12/2014).
Source: Trials - August 20, 2015 Category: Journals (General) Authors: Gillian MeadMaree HackettErik LundströmVeronica MurrayGraeme HankeyMartin Dennis Source Type: research

Interventions for post-stroke fatigue.
CONCLUSIONS: There was insufficient evidence on the efficacy of any intervention to treat or prevent fatigue after stroke. Trials to date have been small and heterogeneous, and some have had a high risk of bias. Some of the interventions described were feasible in people with stroke, but their efficacy should be investigated in RCTs with a more robust study design and adequate sample sizes. PMID: 26133313 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 2, 2015 Category: Journals (General) Authors: Wu S, Kutlubaev MA, Chun HY, Cowey E, Pollock A, Macleod MR, Dennis M, Keane E, Sharpe M, Mead GE Tags: Cochrane Database Syst Rev Source Type: research