Pharmacologic treatment of poststroke depression: a systematic review of the literature

CLINICAL QUESTION/OBJECTIVE: A systematic evaluation of the literature published from 1966 until December 2001 on pharmacologic interventions for poststroke depression (PSD).

Articles were selected from a computer-based search and were independently reviewed by three evaluators using a standardized criteria including internal validity items as well as descriptive and quantitative items.

Fifty studies were preliminarily reviewed and 10 randomized controlled trials (RCTs) were included for systematic analysis.

Selective serotonin reuptake inhibitors (citalopram and fluoxetine) may be effective in the treatment of PSD. There is some evidence for a beneficial effect of the tricyclic antidepressant nortriptyline, however, the RCTs for this medication lack sufficient validity, and reports on side effects are contradictory.