Clinical significance and possibilities of therapy of post-stroke depression

Depression often complicates the course of the post-stroke period, adversely affecting the functional recovery and quality of life of patients, and is associated with an increased risk of mortality. Over the recent years, the role of inflammatory processes, genetics, white matter damage, cerebrovascular reactivity disorders, changes in the level of monoamines and cortisol, impaired neuroplasticity and glutamate neurotransmission in the pathophysiological mechanisms of post-stroke depression (PSD) is increasingly discussed. Randomized clinical trials (RCTs) have shown that antidepressants are highly effective in the treatment and prevention of PSD. The action of antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), can be directed to the main pathophysiological processes of post-stroke depression. Treatment of PSD with antidepressants not only reduces the severity of depression, but also improves the functional state, rehabilitation and quality of life of patients.