The psychopharmacology of brain vascular disease/poststroke depression

Melissa Jones; Amy Corcoran; Ricardo E. Jorge

doi:10.1016/B978-0-444-64012-3.00013-7

The psychopharmacology of brain vascular disease/poststroke depression

Melissa Jones, Amy Corcoran, Ricardo E. Jorge^*

^*Corresponding author for this work

Psychiatry and Behavioral Sciences

Research output: Chapter in Book/Report/Conference proceeding › Chapter

1 Scopus citations

Abstract

Poststroke depression (PSD) is a frequent complication and source of suffering among stroke survivors. Assessment of mood, suicidal ideation, and other neuropsychiatric disturbances that can co-occur or share similar features with depression are important aspects of clinical stroke care. Pharmacotherapy is the first-line treatment of PSD, with selective serotonin reuptake inhibitors (SSRIs) being agents of first choice. The evidence for SSRIs, newer generation antidepressants, and tricyclic antidepressants for PSD will be reviewed with consideration of their side effect profiles and use for other neuropsychiatric comorbidities. Additional therapeutic options, such as cognitive enhancing medications, brain stimulation, and psychotherapy can also be considered. Given the prevalence of PSD, preventive pharmacologic strategies may be effective alternatives. Ultimately, the choice of treatment will be determined by the type and severity of medical and psychiatric comorbidities as well as the preferences of the patient.

Original language	English (US)
Title of host publication	Handbook of Clinical Neurology
Publisher	Elsevier B.V.
Pages	229-241
Number of pages	13
DOIs	https://doi.org/10.1016/B978-0-444-64012-3.00013-7
State	Published - 2019

Publication series

Name	Handbook of Clinical Neurology
Volume	165
ISSN (Print)	0072-9752
ISSN (Electronic)	2212-4152

Keywords

Antidepressants
Depression
Poststroke depression
Stroke

ASJC Scopus subject areas

Neurology
Clinical Neurology

Access to Document

10.1016/B978-0-444-64012-3.00013-7

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abstract = "Poststroke depression (PSD) is a frequent complication and source of suffering among stroke survivors. Assessment of mood, suicidal ideation, and other neuropsychiatric disturbances that can co-occur or share similar features with depression are important aspects of clinical stroke care. Pharmacotherapy is the first-line treatment of PSD, with selective serotonin reuptake inhibitors (SSRIs) being agents of first choice. The evidence for SSRIs, newer generation antidepressants, and tricyclic antidepressants for PSD will be reviewed with consideration of their side effect profiles and use for other neuropsychiatric comorbidities. Additional therapeutic options, such as cognitive enhancing medications, brain stimulation, and psychotherapy can also be considered. Given the prevalence of PSD, preventive pharmacologic strategies may be effective alternatives. Ultimately, the choice of treatment will be determined by the type and severity of medical and psychiatric comorbidities as well as the preferences of the patient.",

keywords = "Antidepressants, Depression, Poststroke depression, Stroke",

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note = "Funding Information: This work was supported by the use of resources and facilities at the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN13-413). The opinions expressed reflect those of the authors and not necessarily those of the Department of Veterans Affairs, the US government, Baylor College of Medicine, or Northwestern University Feinberg School of Medicine. Dr. Jorge received lecture honoraria from Xiang-Jansen Pharmaceuticals. Dr. Jones and Dr. Corcoran have no other financial disclosures to report. Funding Information: This work was supported by the use of resources and facilities at the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN13-413). ",

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