Antidepressants to the rescue! An interruption of blood supply to a part of the brain can have devastating effects for the patient and for those who provide care after the stroke. The most common psychiatric complication of stroke is depression. There is some promising news in the field of stroke therapy now that an international team of researchers report that antidepressants may not only relieve depression but actually improve recovery from disability a year after a stroke.
Heart disease, including heart attacks, may be the number one killer in the US, but strokes, which are essentially “brain attacks”, are number three after cancer. The Centers for Disease Control reports that six million people in the US have suffered a stroke, which is 2.6 percent of the population. Many of these patients, an estimated 30 to 35 percent, develop post-stroke depression as they try to recover. Depression itself, of course, is a common, debilitating disorder affecting nearly 15 million adults in the US.
In the past, there has been disagreement in the scientific literature about the effectiveness of antidepressant use in stroke patients. The new study found that just three months of treatment with the common antidepressant medications fluoxetine and nortriptyline not only relieved depressive symptoms when measured nine months later, but appeared to improve patients’ physical conditions as well. The results raise the possibility that these medications might aid recovery through a mechanism independent of their antidepressant effects.
This mechanism, if it exists, remains to be identified. And the study itself included just 46 patients, 17 of whom received placebo. All the patients were white, married and high school or college educated. Additional studies will be required to determine if the findings apply to a larger population that includes individuals from different socioeconomic classes.
If confirmed, this finding will be good news not just for pharmaceutical companies but for any one recovering from, or helping someone recover from, the effects of a stroke.