Selective serotonin reuptake inhibitors for stroke recovery

This meta-analysis (an analysis of data combined from several similar trials) examined the benefit of selective serotonin reuptake inhibitors (SSRI's) in the rehabilitation of patients who suffered a stroke.

More than half of stroke survivors continue to experience motor deficits (loss of muscle strength or function due to nerve damage) after a stroke. Disabilities following a stroke can reduce a patient's ability to perform activities of daily living, and significantly reduce the quality of life. While recent advances in the care of stroke patients have managed to reduce stroke mortality, no treatment to date has been proven to restore damaged nerve cells.

Serotonin is a neurotransmitter (a molecule used in the body to transmit information between nerve cells) important in the regulation of normal brain and intestinal functions. SSRI's are a class of drugs that raise serotonin levels in the nervous system and are commonly prescribed to treat depression. Some examples of SSRI's include fluvoxamine (Luvox), fluoxetine (Prozac or Fontex), citalopram (Celexa or Cipramil) and paroxetine (Aropax or Seroxat). Recent smaller trials have suggested that SSRI's may help with motor recovery (recovery of muscle strength and function) in stroke patients.

This analysis included a review of 52 trials in which a total of 4059 patients were recruited. Results showed that SSRI treatment improved the level of disability, reduced patient dependency, and improved neurological deficit scores (a scale representing the level of functional nerve damage). The greatest benefit of SSRI therapy was seen in patients suffering from depression. However, SSRI treatment also resulted in an increased risk of seizures, bleeding and gastrointestinal side effects (such as diarrhea or nausea).

In conclusion, this meta-analysis found that SSRI treatment showed a tendency towards improved recovery and reduced levels of patient disability and dependence after a stroke.

Most of the results presented in this analysis are not considered statistically significant. In addition, this analysis included trials with large variations regarding patient characteristics, the time between the stroke and treatment, the type of drug used, the duration of treatment, the methods used to assess outcomes and follow-up periods. This creates a large bias in the presented results, rendering this analysis inconclusive.

Consult with your physician regarding the benefits of selective serotonin reuptake inhibitors in the recovery of stroke patients. If you are suffering from depression following stroke, antidepressant medication may help with recovery.