Antidepressants may help stroke victims

Widely used antidepressants may help patients recover cognitive functions, such as memory skills, that are damaged following a stroke, according to research released Monday.

Escitalopram, a type of selective serotonin reuptake inhibitor, or SSRI, was linked to improved cognitive functioning in a group of stroke patients who did not have symptoms of depression, scientists found.

Previous research showed antidepressants were associated with improved cognitive functioning in stroke patients who were given the drug because they were depressed. The new study, published in the Archives of General Psychiatry and funded by the National Institute of Mental Health, assessed the effect of cognitive functioning in 129 stroke patients who were not depressed.

Participants were treated within three months of the stroke in one of three ways: a low dose -- 5 to 10 milligrams -- of escitalopram, a placebo pill or problem-solving therapy but no medication. (The standard dose of escitalopram, also known by the brand name Lexapro, for treating depression is 20 milligrams.)


After one year, the group on escitalopram had higher scores on tests assessing thinking, learning and memory functions as well as ones testing verbal and visual memory. The group treated with medication also had greater improvements in activities related to daily living.

State-of-the-art stroke care involves use of thrombolytic, or clot-busting, therapies within a few hours of the event. But many patients still need rehabilitation for physical, speech or cognitive problems.

“The question is: Is there a way to improve recovery?” said study lead author Dr. Ricardo E. Jorge, an associate professor of psychiatry at the University of Iowa.

The study was small and would need to be repeated in a larger population before a change in medical practice could be considered, said Dr. Michael Lupo, a spokesman for the American Stroke Assn. and stroke rehabilitation director at Providence St. Joseph Medical Center in Burbank, who was not involved in the research.


Lupo also noted that it was a challenge for researchers to distinguish between depression and cognitive problems in stroke patients.

“Stroke patients can be withdrawn, less focused and have attention problems,” he said. “That is referred to as pseudo dementia. But that can also be just depression.”

It is not clear how an SSRI would contribute to improved cognitive function after a stroke other than by preventing or treating depression.

However, Jorge noted that SSRIs had been shown to increase nerve connections and promote growth of neurons.

The potential risks of antidepressant use among stroke patients are also unknown.

“We didn’t notice any significant safety problems,” Jorge said. “But that doesn’t mean these medications do not have side effects.”