Long-term antidepressant treatment with moclobemide for aphasia in acute stroke patients: a randomised, double-blind, placebo-controlled study.
OBJECTIVE
Pharmacotherapy aimed at stroke rehabilitation through direct central nervous effects may be assumed to work in a similar way for language recovery and sensory-motor recovery. Some data suggest that antidepressant drugs could be beneficial also for functional improvement. This prompted us to investigate whether regression from aphasia after acute stroke could be enhanced by antidepressive drug therapy.


METHODS
We randomised 90 acute stroke patients with aphasia to either 600 mg moclobemide or placebo daily for 6 months, within 3 weeks of the onset of stroke. Aphasia was assessed prior to treatment and at 6 months, using Reinvang's 'Grunntest for afasi' and the Amsterdam-Nijmegen-Everyday-Language-Test (ANELT).


RESULTS
The degree of aphasia decreased significantly at 6 months, with no difference between the moclobemide- and the placebo-treated groups. Multivariate regression analysis including treatment group, activities of daily living, aetiology of stroke, ANELT, and Reinvang's coefficient at baseline, and neurological deficit confirmed these results. In all, 13 in the moclobemide and 10 in the placebo group stopped taking the study medication. No further change was found in the 56 aphasic patients followed up for another 6 months with no medication.


CONCLUSIONS
Compared to placebo, treatment with moclobemide for 6 months did not enhance the regression of aphasia following an acute stroke.
Laska
A C
AC
Division of Internal Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. ann-charlotte.laska@ds.se
von Arbin
M
M
Kahan
T
T
Hellblom
A
A
Murray
V
V
D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide / Q000008:administration & dosage*; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage*; D020521:Stroke / Q000150:complications*; D013997:Time Factors; D017211:Treatment Failure
D008996:Monoamine Oxidase Inhibitors; D020912:Moclobemide