Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Post-stroke depression and the potential for antidepressants to increase the effectiveness of neurorehabilitation

Full Text:


Stroke is the leading cause of disability in adults. Depression after a stroke is detected in one third of patients, complicating physical rehabilitation, worsening functional outcome, increasing mortality rates. The question of the use of antidepressants in the treatment of post-stroke depression is currently not completely resolved, there is no consensus on the most optimal drug. The drugs of choice are selective serotonin reuptake inhibitors, the use of tricyclic antidepressants is possible. A number of clinical studies indicate the effectiveness of selective serotonin reuptake inhibitors in the treatment of post-stroke depression, including through mechanisms including increased neuroplasticity and stimulation of neurogenesis, while others disprove their effectiveness. The article presents a clinical case of the use of vortiroxetin in the patient’s neurorehabilitation in the early recovery period of a stroke, its safety and positive effect are shown.

About the Authors

S. V. Kotov
Vladimirskii Moscow Regional Research Clinical Institute
Russian Federation

E. V. Isakova
Vladimirskii Moscow Regional Research Clinical Institute
Russian Federation

Yu. V. Egorova
Vladimirskii Moscow Regional Research Clinical Institute
Russian Federation


1. Список литературы:

2. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010 [published correction appears in Lancet. 2014 Jan 18;383(9913):218]. Lancet. 2014;383(9913):245-254.

3. Кадыков АС, Черникова ЛА, Шахпаронова НВ. Реабилитация неврологических больных Москва, «МЕДпресс-информ», 2009, 555с.

4. Филатова ЕГ. Постинсультная депрессия. Медицинский совет. 2017; (5): 47-51.

5. Robinson RG, Jorge RE. Post-Stroke Depression: A Review. Am J Psychiatry. 2016;173(3):221–231.

6. Ayerbe L, Ayis S, Wolfe CD, Rudd AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry. 2013;202(1):14-21.

7. Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke. 2014;9(8):1017-1025.

8. Боголепова АН. Роль нейротрофических факторов в развитии постинсультной депрессии. Consilium Medicum. 2019; 21(2):18-23.

9. Kronenberg G, Katchanov J, Endres M. Poststroke-Depression: Klinik, Epidemiologie, Therapie, pathophysiologische Konzepte [Post-stroke depression: clinical aspects, epidemiology, therapy, and pathophysiology]. Nervenarzt. 2006;77(10):1176-1185.

10. Towfighi A, Ovbiagele B, El Husseini N, et al. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017;48(2):e30-e43.

11. Hackett ML, Anderson CS, House A, Halteh C. Interventions for preventing depression after stroke. Cochrane Database Syst Rev. 2008;(3):CD003689. Published 2008 Jul 16.

12. Paolucci S, Iosa M, Coiro P, et al. Post-stroke Depression Increases Disability More Than 15% in Ischemic Stroke Survivors: A Case-Control Study. Front Neurol. 2019;(10):926.

13. Yu S, Arima H, Bertmar C, et al. Depression but not anxiety predicts recurrent cerebrovascular events. Acta Neurol Scand. 2016;134(1):29-34.

14. Hong JP, Park S, Ahn SH, Kim JS. Factors associated with post-stroke suicidal death. J Psychiatr Res. 2018;96:135-137.

15. Chollet F, Rigal J, Marque P, et al. Serotonin Selective Reuptake Inhibitors (SSRIs) and Stroke. Curr Neurol Neurosci Rep. 2018;18(12):100.

16. Kim JM, Stewart R, Kang HJ, et al. A longitudinal study of BDNF promoter methylation and genotype with poststroke depression. J Affect Disord. 2013;149(1-3):93-99.

17. Asadollahi M, Ramezani M, Khanmoradi Z, Karimialavijeh E. The efficacy comparison of citalopram, fluoxetine, and placebo on motor recovery after ischemic stroke: a double-blind

18. Villa RF, Ferrari F, Moretti A. Post-stroke depression: Mechanisms and pharmacological treatment. Pharmacol Ther. 2018;184:131-144.

19. Levada OA, Troyan AS. Poststroke Depression Biomarkers: A Narrative Review. Front Neurol. 2018;9:577.

20. Hackam DG, Mrkobrada M. Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis. Neurology. 2012;79(18):1862-1865.

21. Coupland C, Dhiman P, Morriss R, et al. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ. 2011;343:d4551.

22. D'Anci KE, Uhl S, Oristaglio J, et al. Treatments for Poststroke Motor Deficits and Mood Disorders: A Systematic Review for the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Guidelines for Stroke Rehabilitation. Ann Intern Med. 2019;171(12):906-915.

23. Котов СВ, Исакова ЕВ, Шерегешев ВИ. Возможность коррекции эмоциональных и поведенческих нарушений у пациентов с инсультом в процессе реабилитационного лечения. Журнал неврологии и психиатрии им. C.C. Корсакова. 2019;119(4):26-31.

24. Котов СВ, Исакова ЕВ, Зайцева ЕВ, Червинская АД. Способ реабилитации пациентов с постинсультными нарушениями. Патент на изобретение RU 2688723 C1, 22.05.2019. Заявка № 2018119363 от 25.05.2018.

25. Котов СВ, Исакова ЕВ, Слюнькова ЕВ. Применение технологии нейроинтерфейс "Мозг - компьютер"+экзоскелет в составе комплексной мультимодальной стимуляции при реабилитации пациентов с инсультом. Журнал неврологии и психиатрии им. C.C. Корсакова. 2019;119(12-2):37-42.

26. Зайцева ЕВ, Исакова ЕВ. Эффективность мультимодальной стимуляции при реабилитации пациента после ишемического инсульта. Клиническая геронтология. 2019;25(3-4):64-69.

27. Chollet F, Tardy J, Albucher JF, et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial [published correction appears in Lancet Neurol. 2011 Mar;10(3):205]. Lancet Neurol. 2011;10(2):123-130.

28. Mead GE, Hsieh CF, Lee R, et al. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane Database Syst Rev. 2012;11(11):CD009286.

29. FOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet. 2019;393(10168):265-274.

30. Karaiskos D, Tzavellas E, Spengos K, et al. Duloxetine versus citalopram and sertraline in the treatment of poststroke depression, anxiety, and fatigue. J Neuropsychiatry Clin Neurosci. 2012;24(3):349-353.

31. Sun Y, Liang Y, Jiao Y, et al. Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis. BMJ Open. 2017;7(8):e016499.

32. Bai ZF, Wang LY. Efficacy of sertraline for post-stroke depression: A systematic review protocol of randomized controlled trial. Medicine (Baltimore). 2019;98(16):e15299.

33. Winstein CJ, Stein J, Arena R, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2017 Feb;48(2):e78] [published correction appears in Stroke. 2017 Dec;48(12 ):e369]. Stroke. 2016;47(6):e98-e169.

34. Huang J, Zhou FC, Guan B, et al. Predictors of Remission of Early-Onset Poststroke Depression and the Interaction Between Depression and Cognition During Follow-Up. Front Psychiatry. 2019;9:738.

35. Frampton JE. Vortioxetine: A Review in Cognitive Dysfunction in Depression. Drugs. 2016;76(17):1675‐1682.

For citation:

Kotov S.V., Isakova E.V., Egorova Yu.V. Post-stroke depression and the potential for antidepressants to increase the effectiveness of neurorehabilitation. Neurology, Neuropsychiatry, Psychosomatics. 0;. (In Russ.)

Views: 13

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)