This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fujikawa, T. Articles by Yamawaki, S. Search for Related Content PubMed PubMed Citation Articles by Fujikawa, T. Articles by Yamawaki, S. Pubmed/NCBI databases Medline Plus Health Information Antidepressants

(Stroke. 1996;27:2040-2042.)
© 1996 American Heart Association, Inc.

Articles

Response of Patients With Major Depression and Silent Cerebral Infarction to Antidepressant Drug Therapy, With Emphasis on Central Nervous System Adverse Reactions

Tokumi Fujikawa, MD, PhD; Norio Yokota, MD, PhD; Mitsutaro Muraoka, MD Shigeto Yamawaki, MD, PhD

the Department of Psychiatry and Neurosciences (T.F., N.Y., M.M., S.Y.), Hiroshima University School of Medicine, and Department of Psychiatry (T.F.), National Sanatorium Kamo Hospital, Hiroshima, Japan.

Correspondence to T. Fujikawa, MD, PhD, Department of Psychiatry, National Sanatorium Kamo Hospital, 92 Minamigata, Kurose-cho, Kamo-gun, Hiroshima 724-06, Japan.

Background and Purpose We previously found that silent cerebral infarction (SCI) is present in most patients older than 50 years with major depression. The present study was designed to clarify the response to antidepressant pharmacotherapy in patients with major depression associated with SCI.

Methods Using clinical charts, we retrospectively studied patients older than 50 years who were admitted for antidepressant drug therapy. Patients with bipolar affective disorder and those with focal neurological symptoms were excluded. All patients underwent magnetic resonance imaging and were classified as SCI-negative or SCI-positive. The SCI-positive group was subclassified into those with moderate SCI (either perforating area or cortical area) (n=15) and those with severe SCI (both perforating and cortical areas) (n=7). Duration of treatment in hospital and the incidence of central nervous system adverse reactions to the antidepressant drugs were compared between the two groups.

Results The duration of hospital treatment in patients with severe SCI was significantly longer than in those with moderate SCI (P<.01). The percentage of patients with adverse central nervous system reactions to antidepressant drugs was significantly higher in the SCI-positive group than in the SCI-negative group (P<.05). Patients with severe SCI had significantly more adverse reactions than those with moderate SCI (P<.05).

Conclusions Depressed patients with severe SCI required longer hospital treatment and had more drug-related adverse reactions of the central nervous system. These findings suggest that the depression associated with severe SCI may be resistant to treatment.

Key Words: antidepressive agents • central nervous system • cerebral infarction • depression • magnetic resonance imaging

This article has been cited by other articles:

				S. Lui, L. M. Parkes, X. Huang, K. Zou, R. C. K. Chan, H. Yang, L. Zou, D. Li, H. Tang, T. Zhang, et al. Depressive Disorders: Focally Altered Cerebral Perfusion Measured with Arterial Spin-labeling MR Imaging Radiology, May 1, 2009; 251(2): 476 - 484. [Abstract] [Full Text] [PDF]

				C. Salzman A 60-Year-Old Woman Who Has Felt Sad for Much of Her Life JAMA, January 18, 2006; 295(3): 318 - 323. [Full Text] [PDF]

				D. C. Steffens, K. R. R. Krishnan, C. Crump, and G. L. Burke Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study Stroke, June 1, 2002; 33(6): 1636 - 1644. [Abstract] [Full Text] [PDF]

				J. J. Campbell III and C. E. Coffey Neuropsychiatric Significance of Subcortical Hyperintensity J Neuropsychiatry Clin Neurosci, May 1, 2001; 13(2): 261 - 288. [Full Text] [PDF]

				C. Ugur, D. Gucuyener, N. Uzuner, S. Ozkan, and G. Ozdemir Characteristics of falling in patients with stroke J. Neurol. Neurosurg. Psychiatry, November 1, 2000; 69(5): 649 - 651. [Abstract] [Full Text] [PDF]

				K. Matsuo, T. Kato, M. Fukuda, and N. Kato Alteration of Hemoglobin Oxygenation in the Frontal Region in Elderly Depressed Patients as Measured by Near-infrared Spectroscopy J Neuropsychiatry Clin Neurosci, November 1, 2000; 12(4): 465 - 471. [Abstract] [Full Text]

				T. Fujikawa, I. Yanai, and S. Yamawaki Psychosocial Stressors in Patients With Major Depression and Silent Cerebral Infarction Stroke, June 1, 1997; 28(6): 1123 - 1125. [Abstract] [Full Text]