The Effect Of Prophylactic Antidepressants On The Function Recovery After Stroke

Objective:To study the effect of prophylactic antidepressants on the function recovery in stroke patients.Methods:Poststroke patients (N=281) were randomly assigned to receive Tricyclic Antidepressants(TCA,N=71),Selective Serotonin Reuptake Inhibitors(SSRI,N=80),Serotonin and norepinephrine reuptake inhibitors(SNRI,N=70) or noantidepressant-control (N=60) for 12 weeks, besides traditional treatment after stroke. The TCA-treated patients administered amitriptyline or clomipramine (12.5-50 mg/d).In SSRI group,patients administered citalopram or fluoxetine(20-40 mg/d). Venlafaxine (75～150 mg/d) or dutoxetine(60 mg/d) was taken by patients in SNRI group. The functional outcome was assessed with the Mini-Mental State Examination (MMSE) and Activity of daily living scale (ADL) at baseline,2,4,12 and24 weeks.Results:Of the 281 patients,200 patients had completed 24-week-follow-up,including TCA(N=50),SSRI(N=53),SNRI(N=48) and control group(N=49).The MMSE score of TCA-treated patients was 23.6,23.5,23.7,23.5 and 24.0 at baseline,2,4.12 and 24 weeks.The score was 23.5,23.6,23.8,23.9 and 24.3 in SSRI group. It was 23.5,23.7,23.7,23.8,24.2 in SNRI group and was 23.6,23.4,23.5,22.8,23.5 in control group.The score of ADL was 35.7,34.3,32.8,29.5,26.2 in control group.It was 35.6,33.2,30.1.26.3,23.9 in TCA group,37.3,33.4,29.5,25.2,23.6 in SSRI group and36.0,33.1,29.3,24.9,23.7 in SNRI group.The MMSE score gradually decreased along with time in control group, which was lowest at 12 weeks. While in antidepressant group, the score increased.Cognitive function was better in antidepressant group than control group at 12 weeks (P＜0.05). Activity of daily living in all groups was improved gradually,but it was much better in antidepressant group than control group at 12 weeks.Conclusions:The prophylactic antidepressants can improve fuction recovery at 12 weeks after stroke.