Can SSRI’s Help Recovery From Stroke?

Antidepressants may help people recover from stroke even if they are not depressed

(RxWiki News) Antidepressants can be very helpful for people with depression. Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, may help people recover from a stroke.

Researchers put together all the small trials to see if SSRIs helped recovery from stroke. Even for people who were not depressed, taking an SSRI helped them become less dependent on others and less disabled than people that did not take an SSRI.

The authors suggested that using an SSRI after stroke may be helpful for improving recovery, but said that a large study is needed to make sure.

"Ask a doctor which stroke recovery treatments are best."

The researchers, led by Gillian Mead, MD of the Centre for Clinical Brain Sciences at the University of Edinburgh, UK, reviewed trials that enrolled people within a year after a stroke and used any type of SSRI as a treatment.

SSRIs are a specific type of antidepressant medication. There are nine antidepressants classified as SSRIs. Some commonly used SSRIs are Prozac (fluoxetine), Lexapro (citalopram) and Paxil (paroxetine).

The researchers combined data from 52 trials, which totaled 4,059 people for their analysis.

Then, they looked to see whether using SSRIs after stroke affected recovery. Using an SSRI lowered scores for dependency and disability.  People who took an SSRI after having a stroke were less dependent on others and were less disabled than people who took a sugar pill.

Even when people were not depressed, the SSRI helped reduce dependency and disability.

SSRIs did not improve thinking skills, lower the chances of dying from stroke or improve recovery of physical function. 

The researchers looked to see if one type of SSRI was better than others. They found that no one SSRI performed better than others.

SSRIs were generally safe for people in the studies they reviewed. Some studies reported serious side effects, including bleeding, gastrointestinal side effects and seizure.

The authors said that many of the trials they looked at were not conducted well. All the trials were small and not all the trials recorded side effects. Putting all the data together helped, but the authors still urged caution.

They said, “If these effects are real, and if the risk of side effects is sufficiently low, then SSRIs would become an important (and low cost) treatment for patients with stroke. Thus, there is a need for a larger trial of SSRI in stroke (excluding those with depression) to determine the effect on both the rate of recovery and the ultimate level of disability and dependency.”

This review was published in November in the Cochrane Database of Systematic Reviews. The study was funded by Stroke Research Network in England and the Scottish Stroke Research Network.

Review Date: 
January 17, 2013