Antidepressants Aid in Long-Term Stroke Recovery

CT scan of the brain six days after acute stroke. (Institute for Neurological Research)

A study at University of Iowa in Iowa City finds stroke victims can benefit from a brief treatment of antidepressants, with physical recovery continuing many months after the medication is stopped. The results of the study appeared in a recent issue of the American Journal of Geriatric Psychiatry (paid subscription required).

A team led by psychiatry professor Robert Robinson finds that depressed and non-depressed stroke patients who received antidepressant medication had greater physical recovery after the stroke than patients who received a placebo. Physical improvements in those given medication, compared to those given the placebo, were observed among patients of various ages, hours of rehabilitation, and severity of the initial stroke.

A total of 83 patients who had recent strokes were assigned to receive antidepressants (54 patients) or placebo (29 patients) for three months. The patients’ physical, cognitive and psychiatric symptoms were assessed every three months for one year. Some 36  patients who received antidepressants and 25 of the patients on placebo completed the one-year study.

Using an index of physical and motor disability called the Rankin Scale, the researchers show that antidepressants significantly reduced physical disability over the one-year period compared to placebo. According to the university, the study is the first to demonstrate that physical recovery continues to improve for at least nine months after ending the antidepressant medication.

Current treatment of stroke patients focuses on therapies to restore blood supply to the brain within the first few hours of onset of stroke. Most patients with stroke, however, do not get to a doctor or hospital for treatment in that brief period, or simply do not respond favorably to that treatment.

The study suggests that the antidepressant medication improves physical recovery from stroke, separate from treating depression. Robinson notes that although the mechanisms underlying the effect are still not known, there is evidence that antidepressants can inhibit a type of inflammatory protein that is released in the brain during stroke, and can promote growth of new cells in specific parts of the brain.

The team aims to validate the importance of their findings by testing the effect of antidepressants on physical recovery from stroke in a larger and more diverse group of patients.

Read more: Drug Reduces Stroke Victim Brain Inflammation, Disability

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