Regular Research ArticlesEffect of Antidepressants on the Course of Disability Following Stroke
Section snippets
Patient Selection
A total of 343 patients between 18 and 85 years, who had a stroke in the previous 6 months, were screened for participation in a study of antidepressant therapy. The protocols were approved by the institutional review boards and written informed consent was obtained from each subject. In addition, we required that the subject's immediate family and treating physician also agreed to the subject's participation. Exclusion criteria included: (1) any other significant medical illness that would
Participants
We compared the background characteristics of the patient treated with fluoxetine (N = 32) and those treated with nortriptyline (N = 22) and found no significant differences except there were significantly fewer women in the fluoxetine compared to the nortriptyline group (Fisher's exact test, p = 0.04). Furthermore, mixed model analysis was performed on the mRS of the nortriptyline and fluoxetine groups controlling for age, total hours of physical rehabilitation, baseline NIHSS score, and
DISCUSSION
This study found that the administration of either nortriptyline and fluoxetine for 3 months significantly reduced disability from stroke over 1 year compared with placebo, even after controlling for age, total hours of physical rehabilitation, baseline severity of stroke (using the NIHSS), and baseline HDRS score. To our knowledge, this is the first time that, independent of depression, antidepressant medication has been shown using double blind methodology to be associated with physical
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Cited by (0)
The authors would like to thank Stephanie Rosazza, B.A., study coordinator, and Teresa Kopel, M.A., The University of Iowa.
This work is supported in part by NIH grants R01-MH 40355 and R01-MH65134. Dr. Adams received research support from NIH-NINDS (Consultant R01NS19632, and coinvestigator, 5U01NS041895, both 2001–2009), Mayo Foundation for Medical Education/Research (Coinvestigator, 2000–2009), Boehringer–Ingelheim Pharm (Coinvestigator 2003–2009), Merck, Scherling-Plough, and MNT Medical (2003–2009). Dr. Robinson is a consultant for Avanir Pharmaceutical. Dr. Mikami was supported by a grant from Tokai University, Kanagawa, Japan. Drs. Jorge, Davis, Leira and Ms. Jang have no disclosures to report.
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These authors contributed equally to the manuscript.