The psychopharmacology of brain vascular disease/poststroke depression

Melissa Jones, Amy Corcoran, Ricardo E. Jorge*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

3 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 languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages229-241
Number of pages13
DOIs
StatePublished - 2019

Publication series

NameHandbook of Clinical Neurology
Volume165
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Funding

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. 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).

Keywords

  • Antidepressants
  • Depression
  • Poststroke depression
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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