Post Stroke Depression

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Results of a Pool of Studies Assessingthe Various Potential PersonalDeterminants of PSDFactors associated with post-stroke depressionSignificance in 13 StudiesFactors PositiveNegativeAge 6 6Gender, F 5 6Prior stroke 3 2Prior disability 0 2Prior depression 3 1
Are there stroke-specific factors?•Not really………..just be aware of side-effects•No reason not to follow standard CANMAT treatment guidelines•Start with an adequate trial of one SSRI etc.•Possible exceptions might be severe psychomotor retardationrequiring a stimulating agent such as bupropion or dexedrine•Another factor might be sleep disruption suggestingmirtazepine might be preferred or used in combination•2 recent studies are now regarded as definitive fordepression in general – not just post-stroke (i) STAR*D(NIMH) and (ii) The “Cipriani” study on ComparativeEfficacy and Acceptability of 12 New GenerationAntidepressants
Page 2 and 3: Disclosure of Potential for Conflic
Page 4: Post-Stroke Depression Epidemiology
Page 7 and 8: Depression in Medical illness:The (
Page 9 and 10: PDQ-9 -Example
Page 11 and 12: EMPIRICAL STUDIES•There are many
Page 13 and 14: …but there are positive studies
Page 15 and 16: Recommended ReviewWilliam Feinberg
Page 17: Results of a Pool of Studies Assess
Page 21 and 22: Escitalopram and post-stroke cognit
Page 23 and 24: STAR*D SequencedTreatment Alternati
Page 25 and 26: The Lancet 2009: Cipriani et al.Bac
Page 27: Efficacy Acceptability• Mirtazepi

Post Stroke Depression

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