Fluoxetine beneficial for the prophylaxis of poststroke depression

January 01, 0001

Fluoxetine beneficial for the prophylaxis of poststroke depression

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. The objective of the study by researchers from China is to systematically assess the prophylactic efficacy and safety of fluoxetine for poststroke depression in patients with stroke. The researchers searched electronic databases up to December 2009 for studies evaluating the prophylactic efficacy of fluoxetine in patients with stroke. They 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), helped recovery in neurological function (WMD = -4.72) and improved independence in activities of daily living (WMD = - 8.04); fluoxetine is relatively safe in spite of the adverse events (OR = 0.88, not significant). However, fluoxetine groups and control groups did not differ in change of scores for depression (WMD = -3.97).

The researchers concluded: "Fluoxetine was beneficial for the prophylaxis of poststroke depression in patients with stroke but not in reducing symptom severity of PSD."

From this, it appears the benefit is in early initiation. It would be interesting to see what happens to patients on fluoxetine (or other antidepressants) who have a stroke and maintain their medication compared to others not on it or commenced post-stroke.

For the full abstract, click here.

International Journal of Clinical Practice 64(9):1310-1317, August 2010 © 2010 Blackwell Publishing Ltd
Fluoxetine for the prophylaxis of poststroke depression in patients with stroke: a meta-analysis. Z. M. Yi, F. Liu and S. D. Zhai. Correspondence to F. Liu: [email protected]

Category: Keywords: depression, stroke, fluoxetine, prevention, meta- analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 8 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.