Pharmaceutical interventions for emotionalism after stroke

Area of Science:

• Neurology
• Pharmacology
• Clinical Trials

Background:

• Post-stroke emotionalism, characterized by abnormal crying or laughing, can significantly impact quality of life.
• Antidepressant medications are being explored as a potential treatment for these emotional dysregulations.

Purpose of the Study:

• To evaluate the efficacy of pharmaceutical treatments in reducing emotional displays in post-stroke patients.
• To determine if antidepressant therapy can decrease the frequency of pathological crying and laughing.

Main Methods:

• A systematic review of randomized and quasi-randomized controlled trials was conducted.
• Searched multiple electronic databases and reference lists for studies comparing psychotropic medications to placebo in stroke patients with emotionalism.
• Included five trials with a total of 103 participants.

Main Results:

• Four trials suggested a significant reduction in emotionalism, with up to a 50% decrease in crying and laughing episodes.
• Improvements were noted in the frequency of compulsive laughter and scores on the Pathological Laughter and Crying scale.
• Wide confidence intervals indicate potential for small positive or negative effects; adverse events were rarely reported, but more participants on active treatment left trials early.

Conclusions:

• Antidepressants appear to reduce the frequency and severity of emotional outbursts post-stroke, irrespective of drug class.
• Methodological limitations in the included studies necessitate caution in interpreting results.
• Further high-quality research is required to establish definitive treatment recommendations for post-stroke emotionalism.