[Effective treatment of depression following apoplexy with citalopram]

The aim of the study was to investigate the efficacy and safety of the selective serotonin reuptake inhibitor citalopram in treating post-stroke depression. A six-week double-blind placebo-controlled trial was undertaken. Diagnosis and outcome were determined using the Hamilton Depression Scale, and unwanted effects were measured using the UKU side effect rating scale. Sixty-six consecutive depressed patients entered the trial 2-52 weeks post-stroke. They were assigned to equally sized treatment and placebo groups. The initial level of depression and demographic parameters were comparable in the two groups. Significantly greater improvement was seen in patients treated with citalopram (10-40 mg/day) for three and six weeks. Half of the 28 patients who entered the trial two to six weeks post-stroke recovered within a month, independent of the treatment given. This indicates a high degree of spontaneous recovery in the early phase after stroke. In contrast, placebo recovery was infrequent in patients who started treatment seven weeks or more post-stroke. No serious side effects related to the treatment were detected, those present being mild and usually transient. The trial demonstrates that the selective serotonin reuptake inhibitor citalopram offers an advantageous new treatment of post-stroke depression that is both safe and effective.