| Objective: 1.To study the clinical features in patients with acute post-stroke depression by analyzing 698 inpatients with acute stroke. 2. To investigate the therapeutic effects of antidepressant therapy and the best treatment time by randomizing 75 patients with acute post-stroke depression into different treatment groups. 3.To explore the therapeutic effects of antidepressant and its influence on the neurological function rehabilitation by evaluating the Hamilton depression scale(HAMD), activity of daily living scale(ADL),and nerve deficiency scale in every randomized patient at baseline and after treatment with antidepressant for2, 4 and 8 weeks.Methods: 1. Seventy-five patients with post-stroke depression were selected by inclusion/ exclusion criteria from total of 698 inpatients,who were admitted in the Department of Neurology,Suzhou Municipal Hospital from May 2002 to June 2005. 2. The selected patients were further randomized into 3 groups as following: 1) depressive state group: the patients'depression occurred within 7 days after the onset of stroke; 2) depression group: the patients'depression occurred more than 14 days after stroke; 3) control group: the patients having post-stroke depression but no further antidepressant treatment. 3. The patients in the first group were given fluoxetine (Prozac) within 7 days after the onset of depression. The average treatment time was 5.4 days. The patients in the second group were given Prozac 14 days after the onset of depression. The average treatment time was 16.8 days. Patients in control group weren't treated with any antidepressant drugs. 4. The scores of HAMD, ADL and nerve deficiency scale were evaluated in each patient before anti-depressant therapy(baseline) and after the treatment for 2,4 and 8 weeks.Results: 1.The incidence of depression in patients with cerebral stroke was 26.3% (146/555). The incidence of depression in patients with first cerebral stroke was 27.2% (94/346) and 47.7% (52/109) in patients with multiple cerebral stroke. It seems that the patients with left hemisphere lesions have more chances to get depression since the incidence of depression in these patients was 63.0%(92/146) or 62.7%(47/75). 2. The average HAMD scores of patients in the depressive state group was statistically lower than that in the control group after a 2- week treatment for 4 and 8 weeks('p<0.05), and even lower after treatment for 4 and 8 weeks'(p<0.01). The average HAMD scores of patients in the depression group were also significantly lower after treatment for 4 weeks (p<0.05), and 8 weeks'(p<0.05), compared with that in the control group. On the other hand, the average ADL scores of patients in the depressive state group were higher than that in the depression group after 8–week treatment(p<0.05), and much higher than that in control group(p<0.01). Also, after treatment for 8 weeks, the average ADL scores of patients in the depression group were statistically higher than in the control group(p<0.05).In addition, the average score of nerve deficiency scale in the depressive state group was significantly lower than that in the control group after treatment for 4 and 8 weeks('p<0.05). Similarly, the average score of nerve deficiency scale in the depression group was statistically lower than that in the control group after a 8-weeks treatmen(tp<0.05).Conclusion: The occurrence of depression in patients with cerebral stroke is very common and more frequent in patients with multiple strokes, especially in the patients with left hemisphere lesions. Our study suggested that the early antidepressant treatment could not only improve the symptoms, but also can promote the neurological function rehabilitation. Furthermore, earlier antidepressant treatment (within 7 days) was more effective in patients with post-stroke depression. |
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