title: Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression.
abstract: BACKGROUND
  Poststroke depression is a frequent condition and important to treat. The aim of this trial was to study the efficacy and tolerability of sertraline.
  
  
  METHODS
  In 4 Swedish stroke centers, 123 patients (aged 70.7 +/- 9.9 years) were enrolled during the period September 1998 to January 2001 in a randomized, double-blind, placebo-controlled 26-week trial, at a mean of 128 +/- 97 days (range, 3-375 days) after stroke, if they fulfilled DSM-IV criteria of major depressive episode (N = 76) or minor depressive disorder (N = 47). The primary efficacy variable was a change in depression assessed by the Montgomery-Asberg Depression Rating Scale. The Emotional Distress Scale (EDS) was administered and the occurrence of emotionalism and quality of life (QoL) were assessed, as well as neurologic recovery. Efficacy analyses were intention-to-treat, short-term (week 6) and long-term (week 26).
  
  
  RESULTS
  Of the 123 patients, 62 were treated with sertraline (50-100 mg/day) and 61 with placebo. Both groups improved substantially, with no differences between the treatments, either for major depressive episode or minor depressive disorder, or for short- or long-term antidepressant effect and neurologic outcome. EDS revealed a better outcome with sertraline at week 6 (p < .05). At week 26, the improvement in QoL was better in sertraline patients (p < .05) and there was a trend for emotionalism (p = .07). No serious side effects were seen.
  
  
  CONCLUSIONS
  Poststroke depression as measured by a conventional depression rating scale improved over time irrespective of treatment. Positive effects specific to sertraline were identified in emotional distress, emotionalism, and QoL. The study indicates that poststroke emotional reactions comprise depression and other domains susceptible to pharmacologic therapy.
authors.affiliation: Karolinska Institutet Danderyd Hospital, Division of Medicine, Stockholm, Sweden. veronica.murray@kids.ki.se
authors.forename: Veronica
authors.initials: V
authors.lastname: Murray
authors.forename: Magnus
authors.initials: M
authors.lastname: von Arbin
authors.forename: Aniko
authors.initials: A
authors.lastname: Bartfai
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Berggren
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Landtblom
authors.forename: Jöns
authors.initials: J
authors.lastname: Lundmark
authors.forename: Per
authors.initials: P
authors.lastname: Näsman
authors.forename: Jan-Edvin
authors.initials: JE
authors.lastname: Olsson
authors.forename: Margareta
authors.initials: M
authors.lastname: Samuelsson
authors.forename: Andreas
authors.initials: A
authors.lastname: Terént
authors.forename: Riitta
authors.initials: R
authors.lastname: Varelius
authors.forename: Marie
authors.initials: M
authors.lastname: Asberg
authors.forename: Björn
authors.initials: B
authors.lastname: Mårtensson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline