Post Stroke Depression

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