Key result
Prophylactic administration of antidepressants does not prevent post-stroke depression or improve functional recovery, though SSRIs remain indicated for the treatment of established post-stroke depression.
Why the study?
Post-stroke depression affects one-third of stroke survivors and negatively impacts prognosis, raising questions regarding the role of early antidepressant administration for prophylaxis and treatment.
Does the prophylactic or therapeutic administration of antidepressants prevent or treat post-stroke depression and improve functional recovery in stroke survivors?
Does the prophylactic or therapeutic administration of antidepressants prevent or treat post-stroke depression and improve functional recovery in stroke survivors?
Prophylactic use of antidepressants after stroke is not justified due to lack of efficacy and increased fracture risk, but they remain the first-line treatment for established post-stroke depression.
Avoid prophylactic antidepressants post-stroke; leaves open targeted prevention trials and optimal SSRI timing in established cases.
U tĹetiny pacientĹŻ pĹeĹživĹĄĂch cĂŠvnĂ mozkovou pĹĂhodu se rozvine deprese (post-stroke depression, PSD), kterĂĄ mĂĄ negativnĂ dopad na mortalitu, mĂru postiĹženĂ a celkovou prognĂłzu. ÄasnĂŠ zahĂĄjenĂ podĂĄvĂĄnĂ antidepresiv (AD) by tak mohlo pĹedejĂt rozvoji deprese, a tĂm (Äi souÄasnÄ) zlepĹĄit prognĂłzu pacientĹŻ i v dalĹĄĂch oblastech postiĹženĂ. SĂŠrie recentnĂch multicentrickĂ˝ch studiĂ s fluoxetinem vĹĄak neukazujĂ ĂşÄinnost ani v pĹedchĂĄzenĂ deprese, ani dalĹĄĂch klinickĂ˝ch ukazatelĂch. ProfylaktickĂŠ podĂĄvĂĄnĂ antidepresiv se tak v souÄasnosti jevĂ jako neodĹŻvodnÄnĂŠ. V lĂŠÄbÄ jiĹž rozvinutĂŠ deprese je i nadĂĄle podĂĄvĂĄnĂ AD (SSRI jako prvnĂ volba) indikovĂĄno a dosavadnĂ studie ukazujĂ stĹednÄ vĂ˝znamnĂ˝ ĂşÄinek, velkĂŠ a dlouhodobĂŠ studie jasnÄ doklĂĄdajĂcĂ ĂşÄinnost a bezpeÄnost AD nicmĂŠnÄ dosud chybĂ. SoubÄĹžnÄ rostoucĂ zĂĄjem o neurostimulaÄnĂ a psychosociĂĄlnĂ intervence tak naznaÄujĂ trend k multimodĂĄlnĂ lĂŠÄbÄ PSD.
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Tomáš Novák (2021) conducted a review in Post-stroke depression. Antidepressants vs. Placebo was evaluated. Prophylactic administration of antidepressants does not prevent post-stroke depression or improve functional recovery, though SSRIs remain indicated for the treatment of established post-stroke depression.
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