Depression After Stroke Is Treatable, Study Finds
July 6, 2000 -- A person who has a stroke wakes up in a new world. Abilities
he or she has always taken for granted are lost. Some will be regained in time;
some are gone forever.
It's easy to feel that if you're depressed after a stroke, it's only
natural. And there's not too much you can do about it, right?
Wrong, say researchers from Iowa and Tokyo who've been studying the effects
of treatment on post-stroke depression.
People who experience depression after a stroke should see a doctor for a
thorough evaluation, they say. In many cases, an antidepressant medication will
lighten their mood. There could be other benefits, too: When they do recover
from depression, their families can expect to see improvements such as an
increased ability to speak, remember facts, and pay attention to what's going
How can you tell if someone has serious depression? They feel despondent and
hopeless, says Richard Zorowitz, MD. Their movements slow down. They avoid
activities they used to enjoy. They eat less. They may have trouble sleeping,
or sleep all the time. Zorowitz is an assistant professor of rehabilitation
medicine at the University of Pennsylvania and medical director of the Piersol
Rehabilitation Unit at the University of Pennsylvania Medical Center in
Philadelphia. He was not involved in the current study.
When family members suspect someone who has had a stroke is experiencing
serious depression, they should arrange for an evaluation by a doctor with a
special interest in this subject. It may be a primary care physician, a
neurologist, a psychiatrist, or a neuropsychiatrist, says Robert Robinson, MD,
one of the study's authors. Robinson is head of the psychiatry department and
the Paul Penning Roth professor of psychiatry at the University of Iowa.
"[This] is the first time someone has demonstrated that in patients who
have a major depression following stroke, treating depression has a significant
positive effect on mental functioning," Robinson says. He believes those
who are treated for depression will probably experience improved movement
skills, too; the research team has a study under way on this subject.
In this study, published in Stroke: Journal of the American Heart
Association, researchers looked at 47 patients who were experiencing
depression after a stroke. The patients were treated either with an
antidepressant called nortriptyline (also known as Pamelor or Aventyl) or with
inactive sugar pills over a six- to 12-week period. During the treatment
period, their mental state and ability to function intellectually were
evaluated using standard tests.
A little more than three-quarters of those who received the antidepressant,
and just under a third of those who received the sugar pills, were no longer
depressed by the time the study ended. Their mental abilities, including
language, memory, and hand-eye coordination, showed a distinct improvement.