As if the "normal" recover from a stroke weren't difficult enough, stroke victims show an increased risk of developing depression. In the U.S., more than 700,000 people experience stroke annually. More than half of these patients experience depression following the stroke.
A study in the May 28 issue of JAMA reports that in the year following a stroke, patients who received the medication escitalopram (Lexapro) or participated in a problem-solving therapy group had a lower risk of depression compared to patients who received placebo.
The authors of the JAMA article state,
"Post-stroke depression has been shown in numerous studies to be associated with both impaired recovery in activities of daily living and increased mortality. Prevention of depression thus represents a potentially important goal."
The stated objective of the study was,
"To determine whether treatment with escitalopram or problem-solving therapy over the first year following acute stroke will decrease the number of depression cases that develop compared with placebo medication."
Robert. G. Robinson, M.D., and colleagues at the University of Iowa assessed the efficacy of the anti-depressant drug escitalopram (Lexapro) or problem-solving therapy compared with placebo for the prevention of depression among 176 stroke patients. Within three months following the stroke, the patients were randomized for 12 months into one of three groups:
- problem-solving therapy group
The problem-solving therapy group consisted of six treatment sessions and six reinforcement sessions and included patients selecting a problem and going through steps to arrive at a course of action.
The researchers found:
- participants who received placebo were 4.5 times more likely to develop depression than patients who received escitalopram
- participants who received placebo were 2.2 times more likely to develop depression than patients who received problem-solving therapy
The authors commented,
"Based only on the frequency of depression onset during the one year of treatment, 7.2 acute stroke patients would need to be treated with escitalopram to prevent one case of depression and 9.1 acute stroke patients would need to be treated with problem-solving therapy to prevent one case of depression."