Stroke Victims Recover Thinking, Learning, Memory
by Taking Antidepressant Lexapro
Changes in neuropsychological performance resulted
in an improvement in related activities of daily living
Feb. 1, 2010 - Patients who received the
antidepressant Lexapro (escitalopram)
following a stroke appeared to recover more of their thinking, learning
and memory skills than those taking placebo or participating in
problem-solving therapy, according to a report in the February issue of
Archives of General Psychiatry, one of the JAMA/Archives
journals.
Texan has fed the cows by himself. Stem cells have
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Stroke remains a major health care problem and a
significant cause of death and disability around the world, according to
background information in the article.
Significant recent advances in
the treatment of stroke include the administration of clot-dissolving
therapy, which needs to be administered within the first few hours after
symptoms begin.
"Consequently, besides the efforts currently
undertaken to increase the number of patients treated with thrombolytic
agents, there is growing interest in restorative therapies that can be
administered during the first few months after stroke, the period within
which we observe the greatest degree of spontaneous recovery of initial
motor and cognitive deficits," the authors write.
One line of research has focused on
antidepressants, which may be effective in part because of their ability
to stimulate production of compounds essential for nerve cell growth.
Ricardo E. Jorge, M.D., and colleagues at the
University of Iowa, Iowa City, studied the effects of one antidepressant
- a selective serotonin reuptake inhibitor (SSRI), escitalopram (Lexapro)
- among 129 stroke patients. Within three months of their stroke, 43
patients were randomly assigned to take 5 to 10 milligrams of
escitalopram daily, 45 to take a placebo daily and 41 to participate in
a problem-solving therapy program developed for treating patients with
depression.
After 12 weeks of treatment, patients taking
Lexapro (escitalopram) had higher
scores on neuropsychological tests assessing overall cognitive
(thinking, learning and memory) function and on those measuring verbal
and visual memory.
"Importantly, the reported changes in
neuropsychological performance resulted in an improvement in related
activities of daily living," the authors write.
"The beneficial effect of escitalopram on cognitive
recovery was independent of its effect on depressive symptoms and was
not influenced by stroke type or mechanism of ischemic stroke," they
continue. "In addition, escitalopram was well tolerated and the
frequency of adverse effects related to its administration was not
different than that observed among patients receiving placebo."
Increasing evidence suggests that antidepressants
cause changes in brain structure, including the visual cortex,
hippocampus and cerebral cortex. These structural changes, although not
yet proven to affect behavioral performance, may underlie the
improvements in verbal and visual memory observed in this trial, the
authors note.
"Overall, whatever may be the mechanism of improved
cognitive recovery, this study has shown, for the first time, that
escitalopram, an SSRI, is associated with improved cognitive recovery
following stroke compared with placebo and Problem-Solving Therapy,"
they conclude.
"The utility of antidepressants in the process of
post-stroke recovery deserves to be further investigated."
Chemically, escitalopram is similar to
citalopram (Celexa). Both are in the class of drugs called selective
serotonin reuptake inhibitors (SSRIs), a class that also includes
fluoxetine (Prozac),
paroxetine (Paxil) and
sertraline (Zoloft), according to
MedicineNet.com.
Editor's Note: This work was supported solely by a
grant from the National Institute of Mental Health.
Editors Warning: A small number of
children, teenagers, and young adults (up to 24 years of age) who took
antidepressants ('mood elevators') such as escitalopram during clinical
studies became suicidal (thinking about harming or killing oneself or
planning or trying to do so). Children, teenagers, and young adults who
take antidepressants to treat depression or other mental illnesses may
be more likely to become suicidal than children, teenagers, and young
adults who do not take antidepressants to treat these conditions,
according to a report on MedlinePlus.
Feb. 1, 2010 - Patients who received the
antidepressant 
