Health A to Z

Seniors' Health: Antidepressant improves stroke survivors' brainpower

Patients who have three months of drug treatment show improved thinking ability two years later

Drugs normally given for depression can also improve thinking power in people whose brain has been damaged by a stroke.

A stroke — an interruption in the brain’s blood supply — commonly impairs the survivor’s executive function, which is the ability to perform complex mental tasks such as planning an alternate route home due to unexpected detours.

“Remedies for this condition are limited,” says Dr. Sergio Paradiso, a psychiatrist at the University of Iowa in Iowa City. But he and his colleagues found that antidepressants might be able to help.

The researchers randomly assigned 47 recently diagnosed stroke patients to take an antidepressant or inactive placebo pills for three months. The drugs used were fluoxetine (brand name Prozac) and nortriptyline.

Twenty-one months after the end of the treatment period, the placebo group showed a significant decline in executive function, whereas patients treated with fluoxetine or nortriptyline showed significant improvements, regardless of any change in symptoms of depression.

The researchers measured executive function using a series of tests such as word association and arithmetic skills. They believe antidepressants may improve these skills by reorganizing brain structure and re-establishing nerve connections that were lost because of the death of brain cells during the stroke.

Although the findings of the study are not conclusive, Paradiso says the results provide enough suggestive evidence to endorse fluoxetine or nortriptyline for stroke survivors. “If you want to be conservative, you have to say absolutely that this study has to be replicated with larger numbers,” he says. “But because of the added benefit of adding an antidepressant for cognition but also for prevention of depression (which affects 50 per cent of stroke survivors), I think it’s something that could be tried because right now we are really at a loss for improving cognition in people who have strokes.”

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