title: An exploration of central nervous system medication use and outcomes in stroke rehabilitation.
abstract: Conroy B, Zorowitz R, Horn SD, Ryser DK, Teraoka J, Smout RJ. An exploration of central nervous system medication use and outcomes in stroke rehabilitation.
  
  
  OBJECTIVE
  To study associations between neurobehavioral impairments, use of neurotropic medications, and outcomes for inpatient stroke rehabilitation, controlling for a variety of confounding variables.
  
  
  METHODS
  Observational cohort study of post-stroke rehabilitation.
  
  
  METHODS
  Six inpatient rehabilitation hospitals in the United States.
  
  
  METHODS
  Patients with moderate or severe strokes (N=919).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Discharge disposition, FIM score change, and rehabilitation length of stay (LOS).
  
  
  RESULTS
  Neurobehavioral impairments and use of many medications, including first-generation selective serotonin reuptake inhibitors, older traditional antipsychotic medications, and anti-Parkinsonian neuro-stimulants, have a statistical association with poorer outcomes, whereas use of the atypical antipsychotic medications has a positive association with improvement in motor FIM scores. Counter-intuitively, use of opioid analgesics is associated with a larger motor FIM score change but not an increase in LOS or reduced percentage of discharge to community. There was significant variation in use of neurotropic medications among the 6 study sites during inpatient stroke rehabilitation.
  
  
  CONCLUSIONS
  There are many opportunities to enhance a stroke survivor's ability to benefit from acute inpatient stroke rehabilitation through improved understanding of associations of neurotropic medications with outcomes for different patient groups.
authors.affiliation: Stroke Recovery Program, National Rehabilitation Hospital, Washington, DC, USA.
authors.forename: Brendan
authors.initials: B
authors.lastname: Conroy
authors.forename: Richard
authors.initials: R
authors.lastname: Zorowitz
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.forename: David K
authors.initials: DK
authors.lastname: Ryser
authors.forename: Jeff
authors.initials: J
authors.lastname: Teraoka
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D002491:Central Nervous System Agents