Post-Stroke Care Should Include Antidepressants: New Study
The Houston Chronicle reports that more than 700,000 Americans suffer strokes each year and more than one-third will develop depression in the next two years. Previous research indicates that stroke patients with depression recover more slowly and are more likely to die. However, new research suggests that doctors may want to give stroke victims antidepressants right away instead of waiting until they develop depression.
According to a new study appearing in the Journal of the American Medical Association (JAMA), stroke patients who received low doses of the antidepressant escitalopram (Lexapro), were 4.5 time less likely to develop depression than patients taking a placebo. These results were adjusted for history of mood disorders and remained significant considering possible confounders such age, sex, treatment site, and severity of impairment.
Researchers believe this study has demonstrated that depression can be significantly decreased in frequency by preventive use of escitalopram over the first year following an acute stroke. Although the implications of these findings could lead to more widespread use of antidepressants following strokes, the researchers point out that the limitations of the study need to be acknowledged. One of the major limitations of the study is that it did not include all patients with acute stroke. Patients with life-threatening physical illness, such as cancer or severe cardiac arrhythmia, were excluded. Similarly, patients with severe impairment in verbal comprehension or patients who had already developed a depressive disorder were excluded. Thus, the findings might not be applicable to all stroke victims.
Despite these limitations, researchers are hopeful that the results of this study represent a positive step towards determining whether prevention of post-stroke depression might lead to an increased survival rate and is an important issue for further investigation. The major obstacle to early detection is that studies that have examined the detection of depression during standard stroke care have found that the vast majority of depression cases were overlooked by the treating physicians. The clinical implications of this new study are that patients who are given escitalopram following acute stroke may be spared depression and its adverse consequences.
Previously on the DC Metro Area Medical Malpractice Law Blog, we have posted articles related to:
- May is national stroke awareness month
- FDA warns that spiriva may contribute to stroke risk
- Key to preventing top ten men's health threats
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