title: Fluoxetine treatment in poststroke depression, emotional incontinence, and anger proneness: a double-blind, placebo-controlled study.
abstract: OBJECTIVE
  The efficacy and safety of the selective serotonin reuptake inhibitor fluoxetine have rarely been studied in the treatment of poststroke emotional disturbances.
  
  
  METHODS
  Stroke patients (152) who had poststroke depression (PSD), emotional incontinence (PSEI), or anger proneness (PSAP) were studied. PSD was evaluated by Beck Depression Inventory and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PSEI by Kim's criteria, and PSAP was assessed by Spielberger Trait Anger Scale. Subjects were randomly given either fluoxetine 20 mg/day (n=76) or placebo (n=76) for 3 months. Follow-up evaluations were done 1, 3, and 6 months after the beginning of the treatment. The primary outcome measurement was the scores of emotional disturbances at each follow-up assessment. The secondary outcome measurements were the percentage changes of the scores and the subjective responses of the patients.
  
  
  RESULTS
  Although patients in the fluoxetine group more often dropped out because of adverse effects, fluoxetine administration was generally safe. Fluoxetine significantly improved PSEI and PSAP, whereas no definitive improvement of PSD was found. Improvement of PSAP was noted even at 3 months after the discontinuation of the treatment.
  
  
  CONCLUSIONS
  Fluoxetine is efficacious in the treatment of PSEI and PSAP. Its effect on PSD is not solidly confirmed.
authors.affiliation: College of Nursing, Seoul National University, Seoul, Korea.
authors.forename: Smi
authors.initials: S
authors.lastname: Choi-Kwon
authors.forename: Sung W
authors.initials: SW
authors.lastname: Han
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
authors.forename: Dong-Wha
authors.initials: DW
authors.lastname: Kang
authors.forename: Ji M
authors.initials: JM
authors.lastname: Choi
authors.forename: Jong S
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000786:Anger; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012701:Serotonin / Q000378:metabolism; D020521:Stroke / Q000150:complications* / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D010919:Placebos; D005473:Fluoxetine; D012701:Serotonin