TY - JOUR
T1 - Poststroke Depression
T2 - An Update
AU - Robinson, Robert G.
AU - Jorge, Ricardo E.
AU - Starkstein, Sergio E.
PY - 2024/12/1
Y1 - 2024/12/1
N2 - The presence of neuropsychiatric disorders after stroke has been recognized for more than 100 years, but controlled systematic studies did not begin until the 1970s. The most clinically important advances, however, have been in the treatment and prevention of poststroke depression (PSD). Recent meta-analyses of randomized controlled trials (RCTs) for the treatment of PSD have demonstrated the efficacy of antidepressants. Similarly, RCTs for the prevention of PSD have shown that antidepressants significantly decrease the incidence of PSD compared with placebo. Early treatment of PSD with antidepressants also appears to enhance both physical and cognitive recovery from stroke and may increase survival up to 10 years. Genetic and epigenetic variations, white matter disease, cerebrovascular deregulation, altered neuroplasticity, and changes in glutamate neurotransmission may be relevant etiological factors.
AB - The presence of neuropsychiatric disorders after stroke has been recognized for more than 100 years, but controlled systematic studies did not begin until the 1970s. The most clinically important advances, however, have been in the treatment and prevention of poststroke depression (PSD). Recent meta-analyses of randomized controlled trials (RCTs) for the treatment of PSD have demonstrated the efficacy of antidepressants. Similarly, RCTs for the prevention of PSD have shown that antidepressants significantly decrease the incidence of PSD compared with placebo. Early treatment of PSD with antidepressants also appears to enhance both physical and cognitive recovery from stroke and may increase survival up to 10 years. Genetic and epigenetic variations, white matter disease, cerebrovascular deregulation, altered neuroplasticity, and changes in glutamate neurotransmission may be relevant etiological factors.
KW - Antidepressants
KW - Cerebral Vascular Disease
KW - Depression
KW - Poststroke Depression
KW - Selective Serotonin Reuptake Inhibitors
KW - Stroke Recovery
UR - http://www.scopus.com/inward/record.url?scp=85178887556&partnerID=8YFLogxK
U2 - 10.1176/appi.neuropsych.21090231
DO - 10.1176/appi.neuropsych.21090231
M3 - Article
C2 - 37559511
AN - SCOPUS:85178887556
SN - 0895-0172
VL - 36
SP - 22
EP - 35
JO - The Journal of Neuropsychiatry and Clinical Neurosciences
JF - The Journal of Neuropsychiatry and Clinical Neurosciences
IS - 1
ER -