Key result
SSRIs improve post-stroke recovery but may elevate vascular and bleeding risks.
Why the study?
Depression and psychosocial distress are established risk factors for stroke and post-stroke depression worsens recovery and outcomes, but treatment effects and prevention strategies require clarification.
Novel PSD finding requires validation; leaves open whether targeted interventions enhance rehabilitation outcomes in stroke survivors.
Stroke and depression have a strong bidirectional association: on the one hand, depression and psychosocial distress are well known risk factors for stroke; on the other hand, stroke is known to be a strong risk factor for depression. In the first 2 years after a stroke approximately one-third of patients suffer from a post-stroke depression (PSD). PSD aggravates the burden of physical, psychological, and social disability after stroke, and hinders patient participation in rehabilitation. PSD is associated with a poorer outcome and increased mortality. For the treatment of PSD, selective serotonin reuptake inhibitors (SSRIs) were recommended. Interestingly, SSRIs also have positive effects on motor recovery in stroke patients even without depression, but may increase vascular risk.
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Dirk Sander (2014) conducted a review in Stroke and post-stroke depression. Selective serotonin reuptake inhibitors (SSRIs) vs. Placebo or no treatment was evaluated. Depression and psychosocial distress are independent risk factors for ischemic stroke, and while SSRIs may improve post-stroke depression and motor recovery, they may also increase vascular and bleeding risks.
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