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Common Antidepressant May Aid Brain Function
Taking a common antidepressant may help to repair thinking and memory functions after a stroke, a small study suggests.
The 129 people in the study did not have depression. They were part of another study on prevention of depression after a stroke. Within three months after a stroke, they were randomly assigned to one of three groups. One group took escitalopram (Lexapro), an antidepressant drug. Another group took placebo (fake) pills. The third group took part in a depression therapy program. After 12 weeks, the group taking Lexapro scored better than the others on tests of learning, thinking and memory.
Researchers said the reason is unclear. They said the drug may promote changes in the brain, such as production of new cells. The study appeared February 2 in the journal Archives of General Psychiatry.
What Is the Doctor's Reaction?
In the first three months after a stroke, an antidepressant may be able to improve your recovery of thinking, learning, memory and verbal skills. This important news came from a small study. Researchers published it today in the Archives of General Psychiatry.
The study was simply designed. It included 129 people who had a recent stroke. They were divided into groups that received the antidepressant escitalopram (Lexapro), a placebo pill or neither. The group with no medicine met with a therapist to do "problem-solving" mental exercises.
After three months, people treated with the drug scored better on tests of logic and memory. Memory seemed to improve for both words and pictures. The people in the antidepressant group scored slightly better on one section of a test that aims to measure "functional independence." This includes problem solving, memory, attention and judgment relating to safety issues.
It is difficult to know how large the "real life" benefit may have been, since the change was only measured in test scores. Still, it is a place to start.
How did the antidepressant work? The authors would like to credit the medicine for stimulating brain chemistry. They suggest that it may allow more chemical and electrical connections to form between cells. They may be right.
What Changes Can I Make Now?
If you have recently had a stroke, these treatments might help:
Immediate care -- The most effective treatment for stroke is thrombolysis. This treatment uses a drug that dissolves the clot causing the stroke. With thrombolysis treatment, a person who is having a stroke is less likely to have a lasting disability than someone who does not receive the treatment. Thrombolysis is effective only if given within three hours after symptoms start.
Efforts to prevent a second stroke -- Drug treatment can help to prevent a second stroke. Types of medicines used include:
o High blood pressure drugs
o Aspirin, aspirin with dipyridamole (Aggrenox) or another blood thinner
o Sometimes, medicines for high cholesterol
Physical or occupational therapy -- The first six months are the most important time for recovery of function after a stroke. However, vigorous physical therapy can help some people improve even nine or more months after a stroke. A therapist can help you to become more skilled in using your other side, as well.
Constraint-induced movement therapy -- This unusual form of physical therapy can be helpful for some people after a stroke. The technique usually involves having your fully functional arm held by a splint or restraint for six hours or so each day. This occurs daily for two weeks. The technique forces you to exercise your weak hand and arm to accomplish minor tasks. It can help you to gain maximum use of the limb that has lost function.
Botox -- Injection with botulinum toxin (Botox) may help if you have difficulty moving your hand, arm or leg. Botulinum toxin is used to weaken those muscles that are in spasm. Sometimes this can permit better motion in a joint. A study of botulinum toxin injections in the hands and wrists of stroke patients showed improvement in personal hygiene, dressing, pain and limb position. Botox injections are recommended only if your stroke symptoms have lasted for longer than six months. They are usually given by a neurologist. The injections are always used along with physical or occupational therapy for best results.
Antidepressant medicine -- Yes, I will now add this to my list. The medicine that was studied was escitalopram, 5 to 10 milligrams daily. This is a selective serotonin reuptake inhibitor drug (SSRI). However, any SSRI would likely have a similar effect. Escitalopram causes few side effects. This study treated patients for three months. It is not known whether longer treatment might show added benefit.
What Can I Expect Looking to the Future?
The findings of this study suggest that escitalopram or a similar drug may become part of standard care in the first months after a stroke. More studies will be needed to confirm the apparent benefit of antidepressants on stroke recovery. More research may also show whether longer treatment can help.
The 129 people in the study did not have depression. They were part of another study on prevention of depression after a stroke. Within three months after a stroke, they were randomly assigned to one of three groups. One group took escitalopram (Lexapro), an antidepressant drug. Another group took placebo (fake) pills. The third group took part in a depression therapy program. After 12 weeks, the group taking Lexapro scored better than the others on tests of learning, thinking and memory.
Researchers said the reason is unclear. They said the drug may promote changes in the brain, such as production of new cells. The study appeared February 2 in the journal Archives of General Psychiatry.
What Is the Doctor's Reaction?
In the first three months after a stroke, an antidepressant may be able to improve your recovery of thinking, learning, memory and verbal skills. This important news came from a small study. Researchers published it today in the Archives of General Psychiatry.
The study was simply designed. It included 129 people who had a recent stroke. They were divided into groups that received the antidepressant escitalopram (Lexapro), a placebo pill or neither. The group with no medicine met with a therapist to do "problem-solving" mental exercises.
After three months, people treated with the drug scored better on tests of logic and memory. Memory seemed to improve for both words and pictures. The people in the antidepressant group scored slightly better on one section of a test that aims to measure "functional independence." This includes problem solving, memory, attention and judgment relating to safety issues.
It is difficult to know how large the "real life" benefit may have been, since the change was only measured in test scores. Still, it is a place to start.
How did the antidepressant work? The authors would like to credit the medicine for stimulating brain chemistry. They suggest that it may allow more chemical and electrical connections to form between cells. They may be right.
What Changes Can I Make Now?
If you have recently had a stroke, these treatments might help:
Immediate care -- The most effective treatment for stroke is thrombolysis. This treatment uses a drug that dissolves the clot causing the stroke. With thrombolysis treatment, a person who is having a stroke is less likely to have a lasting disability than someone who does not receive the treatment. Thrombolysis is effective only if given within three hours after symptoms start.
Efforts to prevent a second stroke -- Drug treatment can help to prevent a second stroke. Types of medicines used include:
o High blood pressure drugs
o Aspirin, aspirin with dipyridamole (Aggrenox) or another blood thinner
o Sometimes, medicines for high cholesterol
Physical or occupational therapy -- The first six months are the most important time for recovery of function after a stroke. However, vigorous physical therapy can help some people improve even nine or more months after a stroke. A therapist can help you to become more skilled in using your other side, as well.
Constraint-induced movement therapy -- This unusual form of physical therapy can be helpful for some people after a stroke. The technique usually involves having your fully functional arm held by a splint or restraint for six hours or so each day. This occurs daily for two weeks. The technique forces you to exercise your weak hand and arm to accomplish minor tasks. It can help you to gain maximum use of the limb that has lost function.
Botox -- Injection with botulinum toxin (Botox) may help if you have difficulty moving your hand, arm or leg. Botulinum toxin is used to weaken those muscles that are in spasm. Sometimes this can permit better motion in a joint. A study of botulinum toxin injections in the hands and wrists of stroke patients showed improvement in personal hygiene, dressing, pain and limb position. Botox injections are recommended only if your stroke symptoms have lasted for longer than six months. They are usually given by a neurologist. The injections are always used along with physical or occupational therapy for best results.
Antidepressant medicine -- Yes, I will now add this to my list. The medicine that was studied was escitalopram, 5 to 10 milligrams daily. This is a selective serotonin reuptake inhibitor drug (SSRI). However, any SSRI would likely have a similar effect. Escitalopram causes few side effects. This study treated patients for three months. It is not known whether longer treatment might show added benefit.
What Can I Expect Looking to the Future?
The findings of this study suggest that escitalopram or a similar drug may become part of standard care in the first months after a stroke. More studies will be needed to confirm the apparent benefit of antidepressants on stroke recovery. More research may also show whether longer treatment can help.
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