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Sertraline improves executive function in patients with vascular cognitive impairment
Donald R Royall1, Jeffrey A Cordes, Gustavo Román
1Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, USA. royall@uthscsa.edu
The Journal of Neuropsychiatry and Clinical Neurosciences
|December 10, 2009
Summary
Sertraline treatment showed significant improvements in executive function for patients with ischemic cerebrovascular disease. Many patients experienced meaningful recovery in cognitive control, with some achieving remission of executive impairment.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Neurology
Background:
- Executive impairment is a common challenge following ischemic cerebrovascular disease.
- Current treatments for cognitive deficits post-stroke are limited.
- Sertraline, a selective serotonin reuptake inhibitor, is being investigated for its potential cognitive benefits.
Purpose of the Study:
- To evaluate the efficacy of sertraline in improving executive function in patients with ischemic cerebrovascular disease.
- To determine the rate of clinically meaningful improvement and remission of executive impairment with sertraline therapy.
Main Methods:
- A systematic review and meta-analysis of 35 open-label sertraline trials.
- Assessment of executive function using the Executive Interview (EXIT25), clock-drawing tests, Geriatric Depression Scale, and Mini-Mental State Examination.
- Definition of "clinically meaningful" improvement as >3.0 EXIT25 points decline and "remission" as EXIT25 score <15/50.
Main Results:
- Only EXIT25 scores demonstrated statistically significant improvement.
- 57.1% of patients (20/35) achieved a clinically meaningful improvement in executive control.
- 34.3% of patients (12/35) achieved remission of executive impairment.
Conclusions:
- Sertraline demonstrates both statistical and clinically meaningful effects on executive control function in ischemic cerebrovascular disease.
- These findings support further investigation of sertraline in randomized controlled trials for post-stroke cognitive impairment.
- Sertraline may offer a therapeutic option for managing executive dysfunction in this patient population.
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