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Depression After Stroke Too Often Goes Untreated

As Many as 70% of People Who Are Depressed After Stroke Don’t Get Adequate Treatment
By
WebMD Health News
Reviewed by Louise Chang, MD

March 29, 2012 -- Many people who have a stroke or so-called mini-stroke become depressed afterward, yet up to two-thirds are not getting ample treatment for their depression.

Researchers report that news in the journal Stroke.

"A lot of people are not aware of this risk,” Duke University stroke researcher Nada El Husseini, MD, tells WebMD. “Even if they are feeling depressed, they don’t think it’s relevant.”

But it is. Depression can affect recovery and rehabilitation after a stroke.

“Depression needs to be added to the checklist of things that [stroke] patients need to be evaluated for,” Chad Miller, MD, an Ohio State University associate professor of neurology and neurologic surgery, tells WebMD. Miller reviewed the study for WebMD.

TIA, Stroke, and Depression

A stroke happens when blood flow to the brain is interrupted by a blood clot or bleeding. Stroke is a leading cause of death and disability.

Transient ischemic attacks (TIAs), often called "mini-strokes," involve stroke-like symptoms that don't last long and don't leave lasting damage. But having a TIA does mean a stroke is more likely.

Symptoms of stroke and TIA include:

  • Numbness or weakness in the face, arm, or leg
  • Confusion
  • Double vision or loss of vision
  • Dizziness
  • Trouble walking or talking

Call for emergency medical care if those symptoms occur. Time is crucial for stroke treatment.

Depression Follows Stroke, TIA, but Treatment Lags

The new study included 1,450 U.S. adults who'd had a stroke and nearly 400 who'd had a TIA.  

About 18% of the stroke survivors and about 14% of those who'd had a TIA were depressed three months after hospitalization. Their depression stayed with them -- a year after stroke, about 16% were depressed and so were nearly 13% of those who'd had a TIA. 

Depression was more likely to last in people who were younger, were more disabled by their stroke, and who were unable to return to work three months after their stroke.

Nearly 70% of people with persistent depression weren't being treated with antidepressants at either the three- or 12-month mark, the study shows.

"There is a stunning rate of undiagnosed depression in this group,” Miller says.

Symptoms of depression may include loss of interest in activities that were once pleasurable, feelings of sadness, helplessness, hopelessness, sleep problems, and suicidal thoughts or actions.

“Each stroke doctor is somewhat aware of this [risk], but it may not be one of the priorities,” Miller says. Many stroke specialists focus on addressing risk factors to prevent another stroke from occurring and rehabilitation issues.

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