Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  title={Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials},
  author={See-Hwee Yeo and Zheng-Jie Ian Lim and Jia Mao and Wai-Ping Yau},
  journal={Clinical Drug Investigation},
Background and ObjectivePilot trials have suggested that pharmacotherapy may aid stroke recovery. The aim of this study was to systematically review the effects of antidepressants, anti-Alzheimer drugs, anti-Parkinson drugs, central nervous system (CNS) stimulants and piracetam on gross motor function, cognition, disability, dependency and quality of life (QOL) after stroke.MethodsPubMed, EMBASE and the Cochrane Central Register of Controlled Trials databases were searched, and 44 randomized… 

Efficacy and tolerability of selective serotonin reuptake inhibitors on promoting motor recovery after stroke:meta-analysis of randomized controlled trials

SSRIs are effective and well-tolerated to promote motor recovery after stroke, but may increase the risk of seizures and gastrointestinal adverse effects.

Recovery in Stroke Patients Treated With Fluoxetine Versus Placebo: A Pooled Analysis of 7165 Patients.

The efficacy of fluoxetine on the NIHSS and FMMS is likely to take time to emerge and is expected to be transient, while the use of fluxetine increased the incidence of hyponatremia and bone fractures while decreasing the risk of new-onset depression.

Use of Selective Serotonin Reuptake Inhibitors and Outcomes in Stroke Rehabilitation: A Prospective Observational Pilot Cohort Study

SSRI therapy did not improve disability and QOL in multi-ethnic Asian patients with first-ever stroke undergoing rehabilitation, and no significant association between SSRI therapy and any of the investigated outcomes was found after adjustment for confounders.

Potential Role of Selective Serotonin Reuptake Inhibitors in Improving Functional Outcome after Stroke

The evidence for SSRIs as potential enhancers of stroke recovery is reviewed and the potential mechanisms behind the effects reported and the implications for the management of patients post-stoke are discussed, including potential adverse events and drug–drug interactions.

Pharmacological Interventions to Enhance Stroke Recovery

Serotonin Selective Reuptake Inhibitors (SSRIs) and Stroke

Global coherence is appearing, showing that SSRIs improve stroke recovery in non-depressed patients when given for 3 months after the stroke, with highly favourable safety conditions and a favourable benefit/risk ratio.

Anticholinergic and Sedative Drug Burden and Functional Recovery after Cerebrovascular Accident: A Retrospective Descriptive Study

The study of Japanese patients who were transferred from acute stroke care hospitals to a rehabilitation facility identified the drug burden of anticholinergics and sedatives as an independent factor associated with the time to recovery of activities of daily living and postural balance.

Pharmacological management of post-stroke depression: an update of the evidence and clinical guidance

Although there are still gaps in knowledge of PSD, the seriousness should not be neglected, and pharmacological treatment should be recommended when relevant, and close follow-up and dose adjustments as well as add-on possibilities are important aspects of treatment.

Post-stroke Depression Increases Disability More Than 15% in Ischemic Stroke Survivors: A Case-Control Study

The results confirm the unfavorable influence of PSD on functional outcome, despite pharmacological treatment, despite treatment with serotoninergic antidepressants.



Selective Serotonin Reuptake Inhibitors for Stroke Recovery: A Systematic Review and Meta-analysis

A meta-analysis of all (published and unpublished) randomized controlled trials of SSRI compared with control, given within the first year of stroke, to determine the effect on dependency, disability, and other important clinical outcomes.

Fluoxetine in early poststroke depression: a double-blind placebo-controlled study.

FLX is an efficacious and well-tolerated treatment for early PSD and further research is needed to evaluate the efficacy and safety of long-term treatment in this population.

Prophylactic Effects of Duloxetine on Post-Stroke Depression Symptoms: An Open Single-Blind Trial

The prophylactic use of duloxetine not only decreased the incidence of PSD, but also promoted rehabilitation, cognitive function and quality of life.

Safety of selective serotonin reuptake inhibitor treatment in recovering stroke patients

Evidence suggests that SSRIs may enhance stroke recovery, and several ongoing large randomized trials are awaited beforeSSRIs can be recommended as a routine pharmacotherapy in stroke recovery.

An Open-Label Pilot Study of Acetylcholinesterase Inhibitors to Promote Functional Recovery in Elderly Cognitively Impaired Stroke Patients

In this open-label study, participants receiving donepezil had better functional recovery than participants receiving galantamine or the historical comparators, and this improvement may reflect efficacy at the starting dose fordonepezil but not galantamines.

Methylphenidate in early poststroke recovery: a double-blind, placebo-controlled study.

Effect of Piracetam on Recovery and Rehabilitation After Stroke: A Double‐Blind, Placebo‐Controlled Study

An improvement in aphasia in patients undergoing rehabilitation after a stroke after 12 weeks' treatment with piracetam is shown, but an effect on tests of activities of daily living is unable to be demonstrated and the effect on perceptual deficit is not confirmed.