Abstract W P301: Post Stroke Use of Fluoxetine to Improve Functional Recovery Unrelated to Its Beneficial Effect on Depression
Background: Stroke, the most common cause of long-term disability, is an acute event that can develop into a chronic illness. Recent clinical trials demonstrate that selective serotonin reuptake inhibitors (SSRIs) may be a valuable adjunct to rehabilitation. Following a stroke there is spontaneous reorganization of cerebral motor networks in order to compensate for focal cerebral ischemia. SSRIs are able to optimize this process by stimulating neurogenesis in a manner unrelated to its beneficial effects on depression. Initiating an SSRI post stroke can potentially facilitate a patient’s functional recovery promoting improved quality of life.
Purpose: The purpose of this literature review is to examine whether administration of an SSRI improves functional recovery in post stroke patients without active depression.
Methods: Research published between January 1993 and January 2013 that investigated the use of the SSRI, fluoxetine, to optimize functional recovery after stroke was reviewed. Fluoxetine was chosen due to its favorable safety profile and use in the majority of studies. Only randomized, controlled trials that incorporated concurrent rehabilitation in patients without active depression were examined.
Results: The research demonstrated that fluoxetine has a positive treatment effect on functional recovery. However, due to methodological differences the comparison and pooling of data is limited. Study limitations include small sample size, heterogeneity of stroke type and severity, and time of fluoxetine initiation. Also, measures of functional recovery varied as well as rehabilitation programs.
Conclusion: In conclusion, the opportunity to improve functional recovery through the use of an SSRI post stroke is promising. Future research should establish a consistent methodology in order to further elucidate the role of SSRIs in reducing disability through its augmentation of neurogenesis. If established as an effective adjunct to post stroke rehabilitation, SSRIs may positively impact long-term outcomes.
Author Disclosures: A. Krisak: None.
- © 2014 by American Heart Association, Inc.