Researchers believe that about one-third of patients suffer depression following a stroke and this depression can, in turn, increase the risk of another stroke.
Physicians at Loyola University Medical Center in suburban Chicago write that antidepressant medications such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro), can often relieve the initial depression.
Murray Flaster, M.D., Ph.D., Aparna Sharma, M.D., and Murali Rao, M.D., report in a review article in the journal Topics in Stroke Rehabilitation that mental disorders are common after stroke.
Disorders include anxiety, irritability and agitation, uncontrollable crying, apathy, delusions and hallucinations. However, according to the authors, the most common disorder is depression, either major or minor.
Some patients recover over time, while others move in and out of depression. For some patients, depression doesn’t develop until up to two years after the stroke.
The authors say that post-stroke depression (PSD) is linked to worse functional outcomes and increased risks of suicide and mortality.
Women are more likely to suffer PSD. Other risk factors include living alone and away from family members, higher levels of education, changes in lifestyle or marital status and degree of functional impairment.
Depression, in turn, is a risk factor for stroke and stroke recurrence, even after controlling for other risk factors.
Given the severe effects of PSD, doctors should take an aggressive approach, the researchers said. The timing of medication may be crucial, with early treatment perhaps advantageous.
In addition to helping relieve depression, antidepressants also have been shown to improve cognitive and functional recovery. Recent evidence also shows that SSRIs are helpful in motor recovery (improved movement and coordination).
“Taken together, the available data make a strong case for the prophylactic use and effectiveness of antidepressants post stoke,” the authors write.
Source: Loyola University Medical Center