Antidepressants May Prevent Depression After Stroke

Problem-solving therapy could also make a difference, study shows

By Steven Reinberg
HealthDay Reporter

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TUESDAY, May 27 (HealthDay News) -- Stroke victims often succumb to depression in the months following their attack, but taking an antidepressant may reduce that risk, a new study finds.

To a lesser degree, problem-solving therapy also lowers the chances of depression among stroke victims.

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More than half of the 700,000 people who will have a stroke in the United States this year will develop depression. Depression after stroke is associated with difficulty in recovering the activities of daily life and with an increased risk of death, University of Iowa researchers said in their report.

"The study highlights post-stroke depression, an important clinical problem," said Dr. Larry B. Goldstein, director of the Duke Center for Cerebrovascular Disease at Duke University Medical Center.

"A previous systematic review found that there was insufficient evidence from randomized trials to support the routine use of antidepressants for the prevention of depression or to improve recovery and pointed out the need for further study," Goldstein said. "This small trial provides evidence that pharmacological treatment might decrease the occurrence of post-stroke depression, and that there may be a role for behavioral intervention as well."

The report is published in the May 28 issue of the Journal of the American Medical Association.

In the study, Dr. Robert G. Robinson and his colleagues looked at the effectiveness of the antidepressant Lexapro or problem-solving therapy in preventing depression among people recovering from strokes.

Within three months of a stroke, 176 patients were randomly assigned to receive Lexapro (escitalopram), problem-solving therapy or a placebo. Problem-solving consisted of six sessions, plus an additional six reinforcement sessions, where patients were asked to select a problem and follow steps to solve it.

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