Preventing Poststroke Depression: A 12-Week Double-Blind Randomized Treatment Trial and 21-Month Follow-up
作者:
KENJI,
NARUSHIMA J.,
KOSIER ROBERT,
期刊:
The Journal of Nervous and Mental Disease
(OVID Available online 2002)
卷期:
Volume 190,
issue 5
页码: 296-303
ISSN:0022-3018
年代: 2002
出版商: OVID
数据来源: OVID
摘要:
This study examined the effect of antidepressants in preventing depression after stroke. Nondepressed poststroke patients (N= 48) were randomly assigned to receive nortriptyline, fluoxetine, or placebo for 3 months by using double-blind methodology and were followed-up for 21 months by using a naturalistic design. During the treatment period, one minor depression developed in the nortriptyline group (n= 13 at 3 months), one minor depression developed in the fluoxetine group (n= 13), and five minor depressions developed in the placebo group (n= 15;p< .05). When treatment was discontinued, nortriptyline-treated patients were more likely to develop depression and had significantly more severe depressive symptoms during the next 6 months compared with patients in the other two groups. Both nortriptyline and fluoxetine appeared to be efficacious in preventing depression after stroke. However, nortriptyline produced an increased vulnerability to depression for more than 6 months after it was discontinued. This finding suggests the need to extend prophylactic treatment and monitor patients carefully after the discontinuation of nortriptyline.
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