Key result
Prophylactic nortriptyline or fluoxetine alters correlates of late-onset depression versus placebo in poststroke patients.
Why the study?
The clinical and pathological correlates of poststroke depression following prophylactic antidepressant discontinuation were not well understood.
Does nortriptyline or fluoxetine alter the risk factors and correlates for new onset of depression in nondepressed patients poststroke?
RCT
Double-blind
Randomly assigned
Does nortriptyline or fluoxetine alter the risk factors and correlates for new onset of depression in nondepressed patients poststroke?
The clinical and pathological correlates of late-onset poststroke depression differ depending on prior prophylactic antidepressant use, suggesting subtle differences in pathophysiology.
Answers are grounded in this paper and cite their sources.
Prophylaxis alters poststroke depression correlates; challenges uniform risk-factor models and extends evidence for modifiable pathophysiology.
The authors randomly assigned nondepressed patients at least 3 months poststroke to receive nortriptyline, fluoxetine, or placebo for 3 months using double-blind methodology. Patients were followed at 3, 6, 9, and 21 months for new onset of depression. In patients treated with antidepressants, lesion volume and degree of social impairment were associated with subsequent late-onset of poststroke depression at 6 and 9 months. In the placebo group, severity of impairment in activities of daily living, at 3 and 9 months, was associated with late onset poststroke depression. Differences in the clinical/pathological correlates may reflect subtle differences in the pathophysiology of poststroke depression following prophylactic antidepressants.
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Fiedorowicz et al. (2007) conducted an RCT in Poststroke. Nortriptyline or fluoxetine vs. Placebo was evaluated on New onset of depression. Prophylactic nortriptyline or fluoxetine in poststroke patients altered the correlates of subsequent late-onset depression compared to placebo.
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