Methylphenidate in early poststroke recovery: a double-blind, placebo-controlled study.
OBJECTIVE
To determine the efficacy and safety of methylphenidate in acute stroke rehabilitation.


METHODS
A prospective, randomized, double-blind, placebo-controlled study.


METHODS
Twenty-one stroke patients consecutively admitted to a community-based rehabilitation unit.


METHODS
Three-week treatment of methylphenidate (or placebo) in conjunction with physical therapy. Methylphenidate was started at 5mg and increased gradually to 30mg (15mg at 8:00AM and 15mg at 12:00 noon), and discontinued before discharge.


METHODS
Mood measures included the Hamilton Depression Rating Scale (HAM-D) and Zung Self-Rating Depression Scale (ZDS). Cognitive status was evaluated using the Mini-Mental State Exam (MMSE). Motor functioning was assessed using the Fugl-Meyer Scale (FMS) and a modified version of the Functional Independence Measure (M-FIM). All measures were administered pretreatment and weekly thereafter. Side effects were measured after each increase in dosage and weekly.


RESULTS
Patients receiving methylphenidate treatment scored lower on the HAM-D (F(1,18)=5.714, p=.028), lower on the ZDS (F(1,18)=4.206, p=.055), higher on the M-FIM (F(1,18)=5.374, p=.032), and higher on the FMS (F(1,9)=4.060, p=.075) than patients receiving placebo.


CONCLUSIONS
Methylphenidate appears to be a safe and effective intervention in early poststroke rehabilitation that may expedite recovery.
Grade
C
C
Department of Psychiatry, Milwaukee Clinical Campus, University of Wisconsin School of Medicine, USA.
Redford
B
B
Chrostowski
J
J
Toussaint
L
L
Blackwell
B
B
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000523:psychology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology / Q000534:rehabilitation; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D010555:Personality Inventory; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012803:Sick Role
D000697:Central Nervous System Stimulants; D008774:Methylphenidate