Antidepressants may aid stroke recovery
Antidepressants could reduce disability and dependency after stroke, even in patients who are not depressed, according to new research announced today at the annual UK Stroke Forum in Harrogate.
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A meta-analysis of 52 studies conducted at the University of Edinburgh suggested that a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) may reduce dependence, physical disability, depression and anxiety in the first year after a stroke. Improvements in physical disability were greater in the trials that recruited patients who had depression, yet the study suggested that stroke survivors who are not depressed could also benefit from taking antidepressants.
Professor Gillian Mead, Professor of Stroke and Elderly Care Medicine at the University of Edinburgh says; "Antidepressants have been successfully used for many years to relieve depression. However, it now appears that they also have effects on the brain that may help patients make a better recovery from the physical effects of stroke.
"The results of this meta-analysis are extremely promising. We do not yet fully understand how antidepressants could boost recovery after stroke, but it may be because they promote the growth of new nerve cells in the brain, or protect cells damaged by stroke. Also, by preventing depression, the drugs may help patients to be more physically active which is known to aid overall recovery.
"We now need to carry out a number of much larger clinical trials in order to establish exactly if, how and to what extent antidepressants can help stroke survivors recover."
Recognising the need for further research, the Stroke Association has recently funded the start-up phase of a large trial called Fluoxetine or Control Under Supervision (FOCUS). FOCUS will find out whether receiving fluoxetine treatment, a type of antidepressant, for six months improves recovery for stroke survivors who are between 2 and 15 days after their stroke. It will test whether fluoxetine improves factors such as mood, fatigue, language and memory difficulties as well as overall recovery.
FOCUS is already recruiting patients from two hospitals in Edinburgh and with the support of the UK National Institute of Health Stroke Research Network the trial will soon be recruiting from hospitals all over the UK. It will include 3,000 patients in total.
Dr Dale Webb, Director of Research and Information at the Stroke Association says; "There are now over a million people living in the UK with the disabling effects of stroke. With death rates from stroke declining, it's increasingly important to find new treatments to help survivors make their best possible recovery.
"The results of this meta-analysis are very encouraging and highlight the need for further clinical research trials. If these trials are positive, antidepressants could reduce the disabling effects of stroke in tens of thousands of patients every year.
"However, we are a long way off this type of treatment being offered to stroke patients to reduce the physical effects of the condition. We look forward to the results of further research."
The meta-analysis involved scientists from the UK, Australia, Russia and Taiwan and was supported by UK and Scottish Stroke Research Networks. The results have been published in the Cochrane Library. Over 150,000 people have a stroke every year in the UK, and stroke is the major cause of adult disability.
The UK Stroke Forum is hosted by the Stroke Association and is a coalition of over 30 organisations committed to improving stroke care in the UK. It aims to bring together healthcare professionals in stroke annually to meet and share ideas, and also enables patients to meet stroke professionals and help shape future services. The Stroke Association is launching a report at the UK Stroke Forum demonstrating how research has shaped stroke care over the last 20 years. For more information visit:
