Is it safe to use antidepressants after a stroke?
Depression is an important complication of stroke. Although antidepressants are widely used for the treatment of poststroke depression (PSD), prescription is critically influenced by their safety, tolerability and by the impact on co-morbidities. The authors reviewed the literature on the use of antidepressants after stroke. Selective serotonin re-uptake inhibitors are effective and have a good profile of safety and tolerability in PSD. They are, therefore, used as first-line drugs in the treatment of PSD, although potential cardiovascular and cerebrovascular effects, drug-drug interactions and intolerability in a minority of patients have to be considered. Other antidepressants appear to be safe and effective in selected patients. PSD patients should be classified according to their clinical profile for the selection of the drug of choice in particular sub-groups of patients.
Rampello
Liborio
L
Department of Neurosciences, University of Catania, Azienda Policlinico, via S. Sofia, 78 95123 Catania, Italy. rampello@unict.it
Battaglia
Giuseppe
G
Raffaele
Rocco
R
Vecchio
Ignazio
I
Alvano
Alessandro
A
D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D004347:Drug Interactions; D006801:Humans; D012307:Risk Factors; D012449:Safety; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D020521:Stroke / Q000150:complications* / Q000523:psychology
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors