Meta-analysis Of Controlled Studies Of Fluoxetine For The Treatment Of Post-stroke Depression

Recently, cerebrovascular disease with high prevalence, highmortality and high severe case characteristics has become hot, difficultand focus in the medical research. Post-stroke depression (PSD) is acommon and important neurological complications after stroke. Becausedepression can result in being lack of rehabilitation’s desire andinitiative, unwillingness to contact with the outside world, and evenself-mutilation, self-suicide. So it is one of the most importment causesof disability or even death in patients with stroke. PSD with a higherincidence mainly performs depression and decreases interest. To acertain extent, PSD increases mental suffering of patients and seriouslyaffects neurological rehabilitation of stroke patients and increases thecomplexity of the treatment of physical illness and affects patientscognitive function and declines the quality of life of patients andimproves patients’ mortality and suicide rates. If PSD can be identifiedearly and early improved and eliminated emotional disorders andstrengthened social support and family support and improved cognitivefunction through rehabilitation training, and promoted recovery of neurological function, and gived timely and appropriate antidepressantmedications, it can improve the clinical cure rate. However, the currentsituation of diagnosis and treatment is not optimistic. Because of thelower level of awareness of post-stroke depression, the majority ofpatients, their families and physicians have not paid attention to thesymptoms of depression and inadequately managed.Antidepressant drugs is one of the main measures for the treatmentin the depression after stroke in clinical. Currently the treatment ofPSD’s drugs are traditional tricyclic antidepressants (TCAs), selective5-hydroxytryptamine (5-HT) reuptake inhibitor (Selective SerotoninRe-uptake Inhibitors, SSRIs), and selective NA reuptake inhibitors(NARIs),and so on. Although tricyclic antidepressants may be used totreat post-stroke depression, but that it produces adverse effects (such asarrhythmia, orthostatic hypotension,excessive sedation and excessivetoxicity) affects its clinical application.New antidepressants SSRIs havelittle effect on a variety of receptors, not only retain efficacy, but alsoovercome many adverse reactions of tricyclic antidepressants, andrarely cause sedation, and do not damage psychomotor function, andhave little effect for cardiovascular and autonomic nervous systemfunction. Fluoxetine is a kind of5-serotonin reuptake inhibitors and it is applied to treat PSD home and abroad, but lack of a meta-analysis of alarge-scale evaluation of the clinical efficacy of fluoxetine.This article aims to systematically evaluate the clinical efficacy offluoxetine in the treatment of depression in patients with stroke. Througha systematic literature search in home and abroad medical databases, wecollect and evaluate a total of1524patients identified from17RCTs.The meta-analysis with Revman5.0software indicate that fluoxetinecompared with the control group has significant effects. Compared withthe control group, fluoxetine can significantly decrease the HamiltonDepression Rating Scale scores (P <0.00001, WMD-5.87,95%CI(-7.24～-4.51)), and can promote functional recovery of nerve injury (P<0.00001, WMD-3.45,95%CI (-4.92～-1.97)), and can improve theability of the daily lives (P <0.00001, WMD8.15,95%CI (5.15～11.14))in patients with post-stroke depression.This meta-analysis suggests thatfluoxetine is a selective5-serotonin reuptake inhibitor antidepressants,and its clinical efficacy certainly can be used for the treatment ofpost-stroke depression.