Sertraline for Functional Recovery After Acute Ischemic Stroke: A Prospective Observational Study

Area of Science:

• Neuroscience
• Clinical Neurology
• Pharmacology

Background:

• Selective serotonin-reuptake inhibitors (SSRIs) are explored for neuroprotective and neurorestorative properties.
• Sertraline, an SSRI with favorable pharmacokinetics and fewer side effects, was investigated for its impact on stroke recovery.
• Post-stroke depression (PSD) is a common complication affecting functional outcomes.

Purpose of the Study:

• To investigate the association between sertraline treatment and improved functional recovery in acute ischemic stroke patients with motor deficits.
• To evaluate the effect of sertraline on the incidence of post-stroke depression at 3 months.
• To explore the neurorestorative potential of sertraline in stroke patients.

Main Methods:

• A prospective observational study included acute ischemic stroke patients with motor deficits and pre-stroke functional independence.
• Patients received sertraline for suspected or high-risk post-stroke depression (PSD) or served as controls.
• Functional recovery (modified Rankin Scale ≤2) and PSD (Beck Depression Inventory ≥10) were assessed at 3 months using multivariable logistic regression.

Main Results:

• Sertraline group patients had more severe baseline neurological deficits (NIHSS) and motor deficits compared to controls.
• Adjusted analysis revealed a significant association between sertraline intake and favorable functional recovery at 3 months (OR 3.10, p=0.045).
• No significant difference in the overall frequency of depression was observed, but sertraline was associated with fewer incident cases of depression (p=0.004).

Conclusions:

• Early sertraline treatment may be associated with improved functional recovery in acute ischemic stroke patients.
• Sertraline may help prevent the onset of new depression following a stroke.
• Further investigation in a randomized clinical trial is warranted to confirm these findings.