Depression in stroke victims
Depression often occurs after individuals suffer from a stroke. Approximately 37% of stroke victims deal with resulting depression. However, a recent study published in the Journal of the American Medical Association found that problem-solving therapy or escitalopram within one year of stroke reduces the risk of depression. The following is an excerpt of an article from Medpage Today that reviews the study:
To investigate methods of preventing post-stroke depression, they conducted a multi-site randomized controlled trial among 176 nondepressed patients (mean age 62) within three months of an acute stroke (ischemic or hemorrhagic). Patients were enrolled from July 9, 2003, to Oct. 1, 2007.
The 12-month trial included three groups: a double-blind placebo-controlled comparison of escitalopram (n=59) with placebo (n=58) and a nonblinded problem-solving therapy group (n=59).
Escitalopram, a selective serotonin reuptake inhibitor similar to citalopram (Celexa), was chosen, the researchers said, because of empirical evidence that it might be more effective with a faster onset of action than citalopram and would be better tolerated over a 12-month period.
The drug was given at 10 mg/d in the morning for patients younger than 65 and five mg/day for those 65 or older.
,In the problem-solving therapy, patients selected a problem and then went through steps to arrive at a course of action. The intervention consisted of six treatment sessions over the first 12 weeks and six reinforcement sessions beginning at four months.