In the first year following a stroke, patients who either received the antidepressant escitalopram (Lexapro) or participated in a problem-solving therapy group had a reduced risk of depression compared to those who received a placebo treatment, according to a new study published in the May 28 issue of JAMA.
More than half the patients who have a stroke will experience depression, which is associated with impaired daily functioning as well as increased mortality.
Robert G. Robinson, M.D. and colleagues from the University of Iowa randomized 176 stroke patients into three groups: escitalopram, problem-solving therapy or placebo.
The problem-solving therapy consisted of six treatment sessions and six reinforcement sessions. In the therapy sessions, patients were guided in selecting a problem and developing a course of action for dealing with it.
The researchers found that patients receiving placebo were 4.5 times more likely to develop depression than those who received the antidepressant. They were 2.2 times more likely to develop depression than the therapy group.
Using a more conservative method to analyze the data, however, they found that the escitalopram group was still better than placebo, while the problem-solving therapy group was not significantly better.
"The clinical implications of our findings," said the authors, "are that patients who are given escitalopram or problem-solving therapy following acute stroke may be spared depression and perhaps its adverse consequences."
