Road to recovery: drugs used in stroke rehabilitation

The practice of neurorehabilitation is unique in that it supplements treatments with medications which complement and expedite the rehabilitation process. In stroke rehabilitation, medications can be used not only to treat poststroke secondary complications but also to facilitate recovery. Since only thrombolytics have been demonstrated to be effective in minimizing brain damage and maximizing functional outcome, intensive rehabilitation remains the most significant and important means by which stroke survivors possibly may maximize stroke recovery. There is an opportunity to complement intensive rehabilitation with pharmacologic interventions that facilitate the recovery of damaged neurons as well as plastic responses in underutilized and unused brain tissue. However, few of these medications have been approved for these indications or have been subjected to large randomized clinical trials. Nonetheless, this review identifies areas in stroke rehabilitation that can be addressed with neuropharmacologic agents, lists specific medications currently used to treat these conditions and describes the evidence that supports the recommendations for these medications.