Antidepressant prophylaxis for poststroke depression: a meta-analysis.

Full Abstract

Given the high incidence of poststroke depression, its serious sequelae, and inherent problems with diagnosis, prophylactic use of antidepressants may be a viable management strategy in patients experiencing stroke. The purpose of this study was to assess the prophylactic effects of antidepressants in nondepressed patients with stroke. A meta-analysis of randomized placebo-controlled trials evaluating the prophylactic effects of antidepressants in nondepressed patients with stroke was conducted. Literature searches in MEDLINE, PubMed, CINAHL, PsycINFO, EMBASE, Cochrane library, and CNKI from 1950 to August 2006 were used to identify the relevant studies. Outcome measures included the occurrence rate of newly developed poststroke depression cases and severity of depressive symptoms as indicated by mean depression rating scale scores. The effect size was presented as rate difference or weighted mean difference. From 10 randomized clinical trials, a total of 703 nondepressed patients after stroke were identified. The pooled occurrence rate of newly developed poststroke depression cases in the intervention and control groups were 12.54 (41/327) and 29.17% (91/312), respectively (pooled rate difference=-0.17, 95% confidence interval:
-0.26 to -0.08). Prophylactic effects of antidepressants were not related to duration of use {coefficient of Pearson's correlation [gamma]=0.57, P=0.11}. In conclusion, antidepressant prophylaxis is associated with a significant reduction in the occurrence rate of newly developed poststroke depression, suggesting antidepressants may be considered along with other vascular preventive strategies in the management of stroke patients.

Learn Faster Today Improve your study skills

Author information

Author/s: Chen, Yan (Y); Patel, Nick C (NC); Guo, Jeff J (JJ); Zhan, Siyan (S);

Affiliation: Pharmacoepidemiology and Pharmacoeconomics, Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, Ohio 45267-0004, USA. yance(-atsign-)email.uc.edu

Journal and publication information

Publication Type: Journal Article; Meta-Analysis

Journal: International clinical psychopharmacology (Int Clin Psychopharmacol), published in England. (Language: eng)

Reference: 2007-May; vol 22 (issue 3) : pp 159-66

Dates: Created 2007/04/06; Completed 2007/07/16; Revised 2007/11/15;

PMID: 17414742, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Antidepressive Agents - adverse effects; therapeutic use
Cerebral Infarction - psychology
Depressive Disorder - diagnosis; prevention & control; psychology

Depressive Disorder - diagnosis; prevention & control; psychology
Humans
Randomized Controlled Trials as Topic

Associated Chemicals: Antidepressive Agents (0)

These are the highest related articles currently in the database:

Poststroke depression: psychopharmacological considerations. 29 Sep 2004
Reduction of CSF monoamine metabolites in poststroke depression: a preliminary report. 30 Dec 1991
Depression after stroke: the importance of cerebral hemisphere asymmetries. 30 Dec 1990
A two-year longitudinal study of poststroke mood disorders. In-hospital prognostic factors associated with six-month outcome. 30 Mar 1985
Emotional lability after stroke. 29 Nov 1993
Thalamo-frontal psychosis. 29 Jun 1993
Unreliability of TRH test but not dexamethasone suppression test as a marker of depression in chronic vasculopathic patients. 29 Sep 1996
Blood pressure and intellectual function in elderly subjects. 27 Feb 1997
Poststroke depression and emotional incontinence: correlation with lesion location. 7 May 2000
Single voxel proton magnetic resonance spectroscopy in post-stroke depression. 5 Nov 2006

See 100+ related articles.