Antidepressant may result in improved cognitive function after stroke

Feb 01, 2010

Patients who received the antidepressant escitalopram following a stroke appeared to recover more of their thinking, learning and memory skills than those taking placebo or participating in problem-solving therapy, according to a report in the February issue of Archives of General Psychiatry.

Stroke remains a major health care problem and a significant cause of death and disability around the world, according to background information in the article. Significant recent advances in the treatment of include the administration of clot-dissolving therapy, which needs to be administered within the first few hours after symptoms begin. "Consequently, besides the efforts currently undertaken to increase the number of patients treated with thrombolytic agents, there is growing interest in restorative therapies that can be administered during the first few months after stroke, the period within which we observe the greatest degree of spontaneous recovery of initial motor and cognitive deficits," the authors write.

One line of research has focused on antidepressants, which may be effective in part because of their ability to stimulate production of compounds essential for nerve cell growth. Ricardo E. Jorge, M.D., and colleagues at the University of Iowa, Iowa City, studied the effects of one antidepressant—a (SSRI), escitalopram—among 129 stroke patients. Within three months of their stroke, 43 patients were randomly assigned to take 5 to 10 milligrams of escitalopram daily, 45 to take a placebo daily and 41 to participate in a problem-solving therapy program developed for treating patients with depression.

After 12 weeks of treatment, patients taking escitalopram had higher scores on neuropsychological tests assessing overall cognitive (thinking, and ) function and on those measuring verbal and visual memory. "Importantly, the reported changes in neuropsychological performance resulted in an improvement in related activities of daily living," the authors write.

"The beneficial effect of escitalopram on cognitive recovery was independent of its effect on depressive symptoms and was not influenced by stroke type or mechanism of ischemic stroke," they continue. "In addition, escitalopram was well tolerated and the frequency of adverse effects related to its administration was not different than that observed among patients receiving placebo."

Increasing evidence suggests that antidepressants cause changes in brain structure, including the visual cortex, hippocampus and cerebral cortex. These structural changes, although not yet proven to affect behavioral performance, may underlie the improvements in verbal and visual memory observed in this trial, the authors note. "Overall, whatever may be the mechanism of improved cognitive recovery, this study has shown, for the first time, that escitalopram, an SSRI, is associated with improved cognitive recovery following stroke compared with placebo and Problem-Solving Therapy," they conclude. "The utility of in the process of post-stroke recovery deserves to be further investigated."

Explore further: Pyridoxine-doxylamine drug safety data lacking

More information: Arch Gen Psychiatry. 2010;67[2]:187-196.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Pyridoxine-doxylamine drug safety data lacking

3 hours ago

(Medical Xpress)—The most commonly prescribed drug for pregnant women suffering from morning sickness in their first trimester does not prevent birth defects even though drug safety data says it does, according to research ...

FDA approves new type 2 diabetes drug

20 hours ago

(HealthDay)—Millions of Americans with type 2 diabetes have a new treatment option with the U.S. Food and Drug Administration's approval Tuesday of a once-weekly injectable drug, Tanzeum.

AAFP provides tips to address patients' vaccine concerns

Apr 14, 2014

(HealthDay)—Physicians remain the biggest influence on whether patients get vaccinated, and must be prepared to address patients' reservations, according to an article published in the March/April issue ...

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

Birger
not rated yet Feb 01, 2010
-Would this also be useful for patients with vascular dementia? It is described as lots of "miniature strokes".

More news stories

HIV+ women respond well to HPV vaccine

HIV-positive women respond well to a vaccine against the human papillomavirus (HPV), even when their immune system is struggling, according to newly published results of an international clinical trial. The study's findings ...

Revealing camouflaged bacteria

A research team at the Biozentrum of the University of Basel has discovered an protein family that plays a central role in the fight against the bacterial pathogen Salmonella within the cells. The so cal ...