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(Stroke. 2009;40:e487.)
© 2009 American Heart Association, Inc.

Cochrane Corner

Interventions for Treating Depression After Stroke

Maree L. Hackett, PhD; Craig S. Anderson, PhD, FRACP, FAFPHM; Allan O. House, DM, MRCP, MRCPsych Jun Xia, BA

From the George Institute for International Health (M.L.H., C.S.A.), University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia; the Leeds Institute of Health Sciences (A.O.H.), University of Leeds, UK; and the Cochrane Schizophrenia Group (J.X.), POPE building, Nottingham University, UK.

Correspondence to Maree Hackett, The George Institute for International Health, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. E-mail mhackett@george.org.au

Graeme J. Hankey MD, FRCP Section Editor:

Key Words: depression • stroke recovery • treatment • meta-analysis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Depression is an important consequence of stroke, affecting one third of patients, that often goes undetected or is inadequately treated and managed. This is an update of a Cochrane review we first published in 2004 to determine whether pharmacological, psychological, or electroconvulsive treatment (ECT) of depression in patients with stroke can improve outcome.¹

	Search Strategy

 
We searched the trials registers of the Cochrane Stroke Group (last searched October 2007) and the Cochrane Depression Anxiety and Neurosis Group (last searched February 2008). In addition, we searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2008), MEDLINE (1966 to May 2006), EMBASE (1980 to May 2006), CINAHL (1982 to May 2006), PsycINFO (1967 to May 2006), and other databases. We also searched reference lists, clinical trials registers, conference proceedings, and dissertation abstracts and contacted authors, researchers, and pharmaceutical companies.

	Selection Criteria

 
We considered all truly randomized controlled trials comparing pharmaceutical agents with placebo, or various forms of psychotherapy or ECT with standard care (or attention control), to treat depression in patients with stroke.

	Results

 
We identified 16 trials (17 interventions), with 1655 participants at entry. Data were available for 13 pharmaceutical trials and 4 trials of psychotherapy. There were no trials of ECT. There was evidence of benefit of pharmacotherapy in terms of a complete remission of depression (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.22 to 0.98) and a reduction (improvement) in scores on depression rating scales, but there was also evidence of an increase in adverse events (OR . . . [Full Text of this Article]