Fluoxetine for the prophylaxis of poststroke depression in patients with stroke: a meta-analysis.
BACKGROUND
Depression may affect patients' recovery and even their survival rate after stroke, but it is often overlooked or inadequately managed; data regarding the prophylactic efficacy and safety of fluoxetine are inconsistent in this setting.


OBJECTIVE
The objective of the study is to systematically assess the prophylactic efficacy and safety of fluoxetine for poststroke depression in patients with stroke.


METHODS
We searched electronic databases up to December 2009 for studies evaluating the prophylactic efficacy of fluoxetine in patients with stroke. The pooled odds ratio (OR), weighted mean difference (WMD), incremental efficiency and 95% confidence intervals (95% CI) were calculated.


RESULTS
We collected and evaluated a total of 385 patients identified from six trials. Meta-analysis demonstrated that fluoxetine reduced the incidence of poststroke depression (PSD) (OR = 0.25, 95% CI 0.11 to 0.56), helped recovery in neurological function (WMD = -4.72, 95% CI -8.31 to -1.13) and improved independence in activities of daily living (WMD = -8.04, 95% CI -13.40 to -2.68); fluoxetine is relatively safe in spite of the adverse events (OR = 0.88, 95% CI 0.31 to 2.49, p = 0.82). However, fluoxetine groups and control groups did not differ in change of scores for depression (WMD = -3.97, 95% CI -9.85 to 1.90, p = 0.19).


CONCLUSIONS
Fluoxetine was beneficial for the prophylaxis of poststroke depression in patients with stroke but not in reducing symptom severity of PSD.
Yi
Z M
ZM
Department of Pharmacy, Peking University Third Hospital, Beijing, China.
Liu
F
F
Zhai
S D
SD
D000203:Activities of Daily Living; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000517:prevention & control*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D020521:Stroke / Q000523:psychology*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine