Preventing depression after stroke: Results from a randomized placebo-controlled trial

Area of Science:

• Neurology
• Psychiatry
• Clinical Pharmacology

Background:

• Post-stroke depression is a common and debilitating complication.
• Early intervention is crucial to mitigate the health and financial burden of depression after stroke.

Purpose of the Study:

• To evaluate the efficacy of daily sertraline in preventing depression in acute stroke patients.
• To assess the impact of sertraline on the incidence of depressive symptoms within 24 weeks post-stroke.

Main Methods:

• A double-blind, placebo-controlled trial involving 111 non-depressed acute stroke patients.
• Random assignment to receive either 50 mg of sertraline daily or placebo for 24 weeks.
• Depression assessed via Hospital Anxiety and Depression Scale and physician diagnosis.

Main Results:

• No significant difference in depression incidence between sertraline (16.7%) and placebo (21.6%) groups (p = .590).
• Medication discontinuation rates were similar, often due to side effects or physician-initiated antidepressant use.
• Sertraline was not significantly more effective than placebo in preventing post-stroke depression.

Conclusions:

• Daily sertraline initiated within 2 weeks of stroke onset is not effective in preventing depression at 6 months.
• Development of novel pharmacologic and non-pharmacologic strategies is essential for managing post-stroke depression.
• Addressing the significant health and financial impact of post-stroke depression requires new therapeutic approaches.