Post-stroke depression

Treatment

• Antidepressants appear to be helpful in post-stroke depression, in addition to mood benefit, early treatment of post-stroke depression enhances physical and cognitive recovery as well (Robinson and Jorge, 2016)
• The most consistent risk factor for post-stroke depression is severity of impairment in ADLs. Other risk factors include cognitive impairment and history of depression (Robinson and Jorge, 2016)
• Traditionally, left frontal lesions are associated with depression, though a large scale meta-analysis could not replicate such an association (Wei et al, 2015)
• Treatments with nortriptyline 50-100mg QD, citalopram 10-20mg QD, fluoxetine 20mg QD have proven to significantly reduce symptoms of post-stroke depression (Robinson and Jorge, 2016)

References

Robinson, R. G. & Jorge, R. E. Post-Stroke Depression: A Review. Am. J. Psychiatry 173, 221–231 (2016). https://pubmed.ncbi.nlm.nih.gov/26684921/

Wei, N. et al. Post-stroke depression and lesion location: a systematic review. J. Neurol. 262, 81–90 (2015). https://pubmed.ncbi.nlm.nih.gov/25308633/