A preliminary study of fluvoxamine maleate on depressive state and serum melatonin levels in patients after cerebral infarction.
OBJECTIVE
Antidepressants have been recommended for the treatment of post-stroke depression (PSD). The purpose of this study was to evaluate the effect of fluvoxamine maleate, a selective serotonin re-uptake inhibitor (SSRI), on depressive state, sleep disturbance, and serum melatonin levels in patients with depressive state after cerebral infarction.


METHODS
Nineteen patients who were hospitalized for cerebral infarction and scored 40 points or higher on the Self Depression Scale (SDS) were enrolled in this study. Nine of the 19 patients received fluvoxamine as a treatment group and the other 10 patients were used as untreated controls. Before and after commencing the drug therapy, the patients were assessed by the SDS, Pittsburgh Sleep Quality Index (PSQI), Japan Stroke Scale for Depression (JSSD), and Japan Stroke Scale for Emotional Disturbance (JSSE), and their serum melatonin levels were measured. The control group underwent the same evaluations as the treatment group.


RESULTS
The SDS score improved in the treatment group at 1 week after the start of drug treatment, and in the control group at 1 and 2 weeks into the observation period. In the treatment group, the JSSD and PSQI scores improved and serum melatonin levels increased.


CONCLUSIONS
The administration of fluvoxamine to patients with depressive state after cerebral infarction alleviated both the depressive state and sleep disturbances. Increased melatonin levels by the administration of fluvoxamine may contribute to improvement in sleep disturbance, one of the major symptoms of depression.
Department of Internal Medicine, Division of Neurology, Nippon Medical School, Japan. s2047@nms.ac.jp
Eiko
E
Sunami
Kazuhiro
K
Usuda
Yutaka
Y
Nishiyama
Tatuo
T
Otori
Kenichirou
K
Katsura
Yasuo
Y
Katayama
D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000097:blood / Q000150:complications*; D003863:Depression / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008550:Melatonin / Q000097:blood*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012893:Sleep Wake Disorders / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D020521:Stroke / Q000097:blood / Q000150:complications
D018687:Antidepressive Agents, Second-Generation; D016666:Fluvoxamine; D008550:Melatonin; D017367:Selective Serotonin Reuptake Inhibitors