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Post-stroke treatment with antidepressants appears to reduce death rate

Iowa City, Iowa -- Antidepressant treatment for people who have had stroke -- whether the patients are depressed or not -- appears to increase their chances of living longer, according to a University of Iowa study.

The antidepressants may reduce mortality by decreasing the number of cardiovascular events such as heart attack and recurrent stroke occurring during the follow-up period of both depressed and non-depressed patients who had a stroke. The study involved 104 patients who randomly were assigned to receive nortriptyline (Aventyl or Pamelor), fluoxetine (Prozac) or placebo (inactive substance) for three months after their stroke, and mortality data investigators obtained nine years later. The findings appear in the October issue of the American Journal of Psychiatry.

The relatively small study must be considered preliminary, but the findings are significant, said Ricardo Jorge, M.D., UI assistant professor of psychiatry and the study's co-investigator.

"The study implications are impressive because they indicate patients with stroke may benefit from prevention strategies that use antidepressants to improve recovery and also reduce mortality," Jorge said. "The findings also are important when you take into account that post-stroke depression is so frequent."

Post-stroke depression can occur during the first two years after a stroke. Approximately one in five people who have a stroke develop major depression, while another one in five survivors have less severe depression.

Robert G. Robinson, M.D., the Paul W. Penningroth Professor of Psychiatry, head of the department, and the study's principal investigator, and colleagues previously found that many patients with post-stroke depression who receive antidepressants can improve their activities of daily living (such as bathing oneself or keeping a checkbook) and cognitive function (such as memory and the ability to solve problems).

Robinson and colleagues' previou
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Contact: Becky Soglin
becky-soglin@uiowa.edu
319-335-6660
University of Iowa
29-Sep-2003


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