Prophylactic effects of duloxetine on post-stroke depression symptoms: an open single-blind trial

Post-stroke depression (PSD) is a common yet severe sequela of stroke, and is often accompanied with somatic symptoms. Duloxetine, a new serotonin-norepinephrine reuptake inhibitor, may help to prevent depression after stroke. 95 ischemic stroke patients without depression were randomly divided into two groups: duloxetine group (n = 47) and control group (n = 48). Patients in the control group received routine ischemic stroke therapy, whereas patients in the duloxetine group received duloxetine (dose range 30-90 mg) for 12 weeks in addition to routine therapy. Follow-up observations lasted for 24 weeks. The Hamilton Depression Scale was used to measure depression, and the National Institute of Stroke Scale, Mini-Mental State Examination, Activities of Daily Living Scale (Chinese version) and Short Form 36 Health Survey Questionnaire were used to assess neurological function, cognitive function, rehabilitation from stroke and quality of life. Results showed that in general, duloxetine spared ischemic stroke patients from both minor and major depression by 16%. In addition, duloxetine helped patients to rehabilitate more rapidly from stroke, and was associated with better cognitive function and quality of life. In conclusion, the prophylactic use of duloxetine not only decreased the incidence of PSD, but also promoted rehabilitation, cognitive function and quality of life.