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Interventions for treating anxiety after stroke.

Peter Knapp1, C Alexia Campbell Burton2, John Holmes3

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Summary
This summary is machine-generated.

Anxiety affects 20% of stroke survivors. Current evidence is insufficient to guide treatment with medications or psychological therapies, necessitating further research into effective interventions for post-stroke anxiety.

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Area of Science:

  • Neurology
  • Psychiatry
  • Evidence-Based Medicine

Background:

  • Approximately 20% of stroke patients experience significant anxiety.
  • Treatment options include pharmacotherapy, psychological therapy, or complementary/alternative interventions.
  • This review is an update of evidence published in 2011.

Purpose of the Study:

  • To assess the effectiveness of pharmaceutical, psychological, and complementary/alternative interventions for anxiety in stroke patients.
  • To determine the impact of these interventions on quality of life, disability, depression, social participation, caregiver burden, and mortality.

Main Methods:

  • Searched multiple databases (MEDLINE, Embase, PsycINFO, CINAHL) and trial registers up to January 2017.
  • Included randomized controlled trials of interventions for anxiety in stroke patients.
  • Performed narrative review due to heterogeneity of studies; meta-analysis was not possible.

Main Results:

  • Included three trials with 196 participants investigating relaxation CDs, paroxetine (with or without psychotherapy), and buspirone.
  • Relaxation CD showed a reduction in anxiety (P=0.001). Paroxetine and buspirone also significantly reduced anxiety scores (P<0.01).
  • Evidence quality was very low due to small sample sizes, limited reporting, and potential biases. Adverse events were noted for paroxetine and buspirone.

Conclusions:

  • Insufficient evidence exists to guide the treatment of anxiety post-stroke.
  • Further high-quality randomized controlled trials with placebo or attention controls are needed.
  • Research should focus on both pharmacological agents and psychological therapies for stroke-related anxiety.