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Antidepressants May Aid Stroke Rehabilitation

Stroke Patients Taking Prozac Recovered More Physical Function Than Those on Placebo
By
WebMD Health News
Reviewed by Laura J. Martin, MD

Jan. 9, 2011 -- New research suggests that selective serotonin reuptake inhibitor (SSRI) antidepressants may help people move again after a stroke.

“I think the study is quite exciting,” says Robert Robinson, MD, a neuropsychiatrist who is the Paul Penningroth chair of psychiatry at the University of Iowa.  “It is the largest trial to date that has demonstrated that the use of an antidepressant medication can augment the physical recovery from stroke.”

The study is part of a small but growing cache of evidence that suggests that SSRI antidepressant medications such as Celexa, Lexapro, Paxil, Prozac, and Zoloft may help stroke patients not simply by relieving mood symptoms, which can hinder recovery in their own right by causing people to feel hopeless and tired, but also by helping neurons grow and re-establish connections in the brain that are vital for physical functioning.

If further research continues to confirm the finding, experts say SSRI antidepressants would be only the second kind of drug therapy found to offer any benefit to stroke patients.

The most common drug, a clot buster, must be administered within hours of the stroke to be effective; and studies suggest up to 90% of people who have strokes don’t get to the hospital fast enough to benefit from it.

Significant Improvement in Function

The new study, which is published in The Lancet, looked at improvements in paralysis and weakness in 118 ischemic stroke patients in France who were randomly assigned to receive either 20 milligrams of Prozac or a placebo each day for three months beginning 5-10 days after stroke onset. All study participants received physical therapy.

On average, after 90 days, patients in the Prozac group had improved 34 points on a 100-point stroke symptom scale. Patients in the placebo group, on the other hand, saw a 24-point improvement. The improvement remained even when researchers adjusted the study results to exclude patients who’d developed depression. The study was sponsored by the French government.

Experts say the finding means SSRI antidepressant medications could make the difference between someone needing help to get out of bed or to walk and being able to do those daily activities on their own.

“We’re not talking about a couple of points on the scale as happens in Alzheimer’s disease where the improvement in barely noticeable,” says Robinson, who co-authored an editorial on the study. “We’re talking about patients who are a whole category improved. We’re talking about clinically and significantly bigger improvement for the patient and their family.”

Robinson has conducted similar studies, one with the drug Prozac and other with the drug Lexapro, which followed patients for up to a year after their strokes.

“Even when you stop the drug, the recovery continues for at least another nine months,” he says.

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