Abstract Details

Title Review of Current Pharmacotherapy for Post-Stroke Depression

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-022

Objective

The objective of this review is to highlight the dearth of data on post-stroke depression (PSD), its effect on recovery and current antidepressant usage practices.

Background

Post-stroke depression is a common neuropsychiatric sequelae of stroke, and is associated with increased mortality and poor outcome. As indicated in recent 2018 AHA/ASA Guidelines for management of ischemic stroke, little is known about the preferred screening method, timing to diagnose and recommended treatment.

Design/Methods

Extensive search of electronic databases was conducted, and published articles from 2008-current were identified for this review. Of the 47 original contributions, using pre-determined inclusion criteria such as treatment trials, use of antidepressant, and valid assessment of PSD, the search was narrowed to 13 total studies, which were finally reviewed and analyzed by the first author.

Results The majority of studies were small trials (n=19-478) comparing the effectiveness of antidepressants for PSD compared to control, with the most studied antidepressant being Escitloptram. Antidepressants were generally beneficial in reducing PSD, except for one study in Lancet Psychiatry (n=478) that showed Escitalopram 10 mg had no significant reduction of depression compared to placebo. In other smaller studies (n=115-154), Escitalopram 10 mg prevented new onset of apathy and increased survival. Two trials (n=60-95) evaluated Duloxetine, with one suggesting prophylactic administration of 30-90mg Duloxetine for 12 weeks decreases incidence of PSD, and the other showing 60-120 mg Duloxetine was better at treating PSD than Citalopram or Sertraline. In patients (n=83) taking Fluoxetine 10-30 mg, there was better functional recovery one-year post stroke.

Conclusions Although there is general consensus that antidepressant treatments are beneficial in PSD, there is limited data from randomized clinical trials comparing effectiveness of antidepressants, and recommended treatment duration and dosing. The review highlights the unmet requisite for larger, more inclusive studies providing higher level of scientific evidence assisting in screening and management of PSD.

Authors/Disclosures
Fasiha Syed PRESENTER	No disclosure on file
Nabeel Herial, MD, MPH, FAAN (Albany Medical Center)	Dr. Herial has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medtronic.

��ɫ��

��ɫ��