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Post-stroke treatment with antidepressants appears to reduce death rate

s analysis also showed that stroke patients with depression die at a faster rate than stroke patients who are not depressed, and this higher death rate has been linked to cardiovascular events.

The current analysis used the initial data from the previous research and mortality data obtained nine years later. Half of the patients who received antidepressants actually were depressed at the start of the study (27 of 53), and 46.4 percent of patients receiving placebo were depressed at baseline (13 of 28). Of the 104 patients in the study, 23 did not complete their initial assignment to take either one of the antidepressants or the placebo for 12 weeks.

The researchers found that nearly 68 percent of the patients who received all 12 weeks of antidepressant treatment were alive after nine years (36 of 53 patients), compared with about 36 percent of patients who received 12 weeks of the inactive substance (10 of 28 patients).

Analysis of the causes of death revealed that patients who received antidepressants were less likely to die from cardiovascular problems than patients who did not receive antidepressants. Thirty percent of the patients, depressed or not, who received antidepressants and died within nine years died from cardiovascular causes. In contrast, nearly 55 percent of patients who did not receive adequate antidepressant therapy and died during the same period died from cardiovascular causes.

Jorge said antidepressants may provide protective effects in several ways, both behaviorally and physiologically. For one, depressed patients may not comply with treatments. For example, a person who is depressed after a stroke and has diabetes may poorly control their diabetes by failing to eat properly and failing to take medications. However, a non-depressed person with diabetes may be more attentive to these important self-care measures.

Depression also may be associated with changes in platelet function. Platelets play a role
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Contact: Becky Soglin
becky-soglin@uiowa.edu
319-335-6660
University of Iowa
29-Sep-2003


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