Antidepressants improve post-stroke 'thinking outside the box'

Antidepressant treatment appears to help stroke survivors with the kind of complex mental abilities often referred to as "thinking outside the box," according to a University of Iowa study.

The antidepressants' effects on study participants' abilities were independent of any changes in depression. In addition, the improvements in complex mental abilities were not seen immediately but during the course of 21 months after the treatment ended. The study results appear in the March 2007 issue of the British Journal of Psychiatry.

Antidepressant treatment already was known to improve mood in depressed post-stroke patients, but such therapy had not been examined on executive function in people with clinically diagnosed stroke, said Sergio Paradiso, M.D., Ph.D., the study's corresponding author and assistant professor of psychiatry at the UI Carver College of Medicine.

"We found that people diagnosed with stroke who often have a decline in 'executive function', that is, those mental abilities that enable us to respond appropriately to unfamiliar or complex situations, and support several cognitive, emotional and social capacities, showed improvement after receiving a 12-week treatment with antidepressants," Paradiso said.

Executive functions come into play, for instance, when we plan to take an alternative route home due to unexpected detours. This brain function involves stopping ingrained behavior, such as trying to take your usual route home. People with stroke often show impairments in executive function and may not be able to respond well to non-routine situations. This impairment may affect rehabilitation efforts.

The UI team included Kenji Narushima, M.D, Ph.D., UI resident physician in psychiatry, who contributed significantly to the study.

The study began with 47 patients who had had a stroke during the previous six months. These individuals were divided into three groups and randomly assigned (with

Contact: Becky Soglin
University of Iowa

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