Treatment issues in poststroke depression

Depression is perhaps the most frequent emotional disorder to occur after a stroke. These depressions may be either major or minor in type and usually remit within the first year after the stroke. In addition to emotional suffering, poststroke depression has been associated with inhibited physical recovery, impaired cognitive functioning, and increased mortality. Determining whether these consequences of stroke may be improved by treatment of depression constitutes both a major challenge and an enormous opportunity for new approaches to poststroke pharmacotherapy. Previous controlled and uncontrolled treatment trials have provided partial support for the hypothesis that mood, cognitive, physical, and survival consequences of poststroke depression may be improved by antidepressant therapy.