Effect of antidepressant therapy on executive function after stroke.
BACKGROUND
Executive dysfunction is common after stroke and may impair long-term outcome. Remedies for this condition are limited.


OBJECTIVE
To examine the effect of antidepressants on executive function after stroke.


METHODS
Forty-seven patients who had had a stroke during the prior 6 months received 12 weeks of antidepressant treatment in double-blind placebo-controlled fashion, followed by assessment of executive function at the end of treatment and after 2 years.


RESULTS
No significant group effect was found at the end of treatment. However, 21 months after the end of treatment the placebo group showed deterioration of executive function, whereas the active treatment group showed clear and significant improvement independent of depressive symptoms (F=12.1, d.f.=1,45, P= 0.001).


CONCLUSIONS
Antidepressant treatment fosters long-term improvement of executive function following stroke. This phenomenon is consistent with a reorganisation of neuronal networks associated with prefrontal functions based on modulation of monoaminergic neurotransmission and the activity of neurotrophins.
Narushima
Kenji
K
University of Iowa Carver College of Medicine, Department of Psychiatry, 200 Hawkins Drive, W278 GH, Iowa City, IA 52242, USA.
Paradiso
Sergio
S
Moser
David J
DJ
Jorge
Ricardo
R
Robinson
Robert G
RG
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D012044:Regression Analysis; D020521:Stroke / Q000523:psychology*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D005473:Fluoxetine; D009661:Nortriptyline