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Post Stroke Depression Treatment Medication

About 40 to 50 percent of patients who survive a stroke develop post-stroke depression, according to UIHealthcare.com. Effective treatment can enhance quality of life and improve rehabilitation outcomes.

  1. Effects of Stroke

    • Strokes vary in their effect, depending on the amount of tissue damage, the location of the stroke in the brain, level of pre-stroke brain functioning, idiosyncrasies of the patients’ brain structure and collateral damage to surrounding regions of the brain. Effects can range from mild weakness and difficulty finding words to paralysis, weakness, loss of motor control, and disturbance in thinking, feeling, writing, memory, speech and emotional functioning.

    Post-Stroke Depression

    • Depression is a common effect of stroke. Depression may be a direct consequence of brain damage from the stroke, or may be a response to emotional and lifestyle losses imposed by the effects of the stroke.

    Importance of Treatment

    • Post-stroke depressions can last seven to eight months or even longer without treatment. Post-stroke depression is associated with failure to achieve premorbid (i.e., pre-stroke) levels of functioning. Medication and treatment of depression can contribute to improvement of emotional functioning and to overall rehabilitation outcomes.

    Medication and Post-Stroke Depression

    • Overall, the occurrence of stroke does not prohibit the use of antidepressant medications, and in general potential advantages outweigh risks. Careful supervision and monitoring of toxicity and side effects should be maintained. Several classes of antidepressants have been studied as treatment for post-stroke depression including selective serotonin reuptake inhibitors and tricyclics.

    SSRIs

    • Selective serotonin reuptake inhibitors increase levels of the brain chemical serotonin to areas of the brain that control emotional functioning. SSRIs such as fluoxetine appear to improve depression and aid other aspects of post-stroke emotional functioning such as limiting or eliminating excessive, inappropriate laughing or crying.

    Tricyclics

    • Tricyclics may work better than SSRIs for post-stroke depression, at least for patients who don’t have conditions such as heart disease that preclude taking tricyclics. For example, one study described at PSLGroup.com, indicates that post-stroke patients who took nortriptyline, a tricyclic, showed greater improvement in depression and in behavioral functioning such as self-care and autonomy than patients who were given fluoxetine.

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