disease interaction(s) of stroke with depression
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Epidemiology
- common
Complications
- impairs recovery
- increases mortality in patients < 65 years of age[6]
Management
- treatment of depression can improve recovery[2]
- cognitive behavorial therapy[1]
- antidepressants are effective, but only in some patients
- nortriptyline may be superior to fluoxetine[1][3]
- citalopram & & trazodone have been shown beneficial[3]
- antidepressants may improve survival in patients with or without depression[4]
- SSRI initiated after stroke increases mortality[6] (RR=1.7, independent of depression)
More general terms
References
- ↑ 1.0 1.1 1.2 Mitchell PH et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant. Living Well With Stroke: Randomized controlled trial. Stroke 2009 Sep; 40:3073. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19661478
- ↑ 2.0 2.1 Prescriber's Letter 7(9):53 2000
- ↑ 3.0 3.1 3.2 Robinson RG et al, Escitalopram and problem-solving therapy for prevention of poststroke depression: A randomized controlled trial. JAMA 2008, 299:2391 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18505948
- ↑ 4.0 4.1 Prescriber's Letter 10(12):68 2003
- ↑ Pan A et al Depression and Incident Stroke in Women Stroke August 11, 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21836097 <Internet> http://stroke.ahajournals.org/content/early/2011/08/11/STROKEAHA.111.617043.abstract
Pan A et al Depression and Risk of Stroke Morbidity and Mortality: A Meta-analysis and Systematic Review <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21934057 <Internet> http://jama.ama-assn.org/content/306/11/1241.abstract - ↑ 6.0 6.1 6.2 Ayerbe L et al. Explanatory factors for the increased mortality of stroke patients with depression. Neurology 2014 Nov 25; 83:2007. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25355829 <Internet> http://www.neurology.org/content/83/22/2007
Bartoli F and Paolucci S. Association of depression and SSRIs with mortality after stroke. Neurology 2014 Nov 25; 83:1998. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25355834 <Internet> http://www.neurology.org/content/83/22/1998 - ↑ Depression and Stroke http://www.nimh.nih.gov/publicat/depstroke.cfm