Escitalopram and enhancement of cognitive recovery following stroke

Ricardo E Jorge; Laura Acion; David Moser; Harold P Adams Jr; Robert G Robinson

doi:10.1001/archgenpsychiatry.2009.185

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Escitalopram and enhancement of cognitive recovery following stroke

Journal article

Open access

Peer reviewed

Escitalopram and enhancement of cognitive recovery following stroke

Ricardo E Jorge, Laura Acion, David Moser, Harold P Adams Jr and Robert G Robinson

Archives of general psychiatry, Vol.67(2), pp.187-196

02/2010

DOI: 10.1001/archgenpsychiatry.2009.185

PMCID: PMC3718472

PMID: 20124118

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Abstract

Adjunctive restorative therapies administered during the first few months after stroke, the period with the greatest degree of spontaneous recovery, reduce the number of stroke patients with significant disability. To examine the effect of escitalopram on cognitive outcome. We hypothesized that patients who received escitalopram would show improved performance in neuropsychological tests assessing memory and executive functions than patients who received placebo or underwent Problem Solving Therapy. Randomized trial. Stroke center. One hundred twenty-nine patients were treated within 3 months following stroke. The 12-month trial included 3 arms: a double-blind placebo-controlled comparison of escitalopram (n = 43) with placebo (n = 45), and a nonblinded arm of Problem Solving Therapy (n = 41). Change in scores from baseline to the end of treatment for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail-Making, Controlled Oral Word Association, Wechsler Adult Intelligence Scale-III Similarities, and Stroop tests. We found a difference among the 3 treatment groups in change in RBANS total score (P < .01) and RBANS delayed memory score (P < .01). After adjusting for possible confounders, there was a significant effect of escitalopram treatment on the change in RBANS total score (P < .01, adjusted mean change in score: escitalopram group, 10.0; nonescitalopram group, 3.1) and the change in RBANS delayed memory score (P < .01, adjusted mean change in score: escitalopram group, 11.3; nonescitalopram group, 2.5). We did not observe treatment effects in other neuropsychological measures. When compared with patients who received placebo or underwent Problem Solving Therapy, stroke patients who received escitalopram showed improvement in global cognitive functioning, specifically in verbal and visual memory functions. This beneficial effect of escitalopram was independent of its effect on depression. The utility of antidepressants in the process of poststroke recovery should be further investigated. Trial Registration clinicaltrials.gov Identifier: NCT00071643.

Neuropsychological Tests

Cognition Disorders - diagnosis

Cognition Disorders - etiology

Humans

Problem Solving

Serotonin Uptake Inhibitors - therapeutic use

Stroke - complications

Citalopram - therapeutic use

Female

Male

Aged

Details

Title: Subtitle: Escitalopram and enhancement of cognitive recovery following stroke
Creators: Ricardo E Jorge - Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1000, USA. ricardo-jorge@uiowa.edu
Laura Acion
David Moser
Harold P Adams Jr
Robert G Robinson
Resource Type: Journal article
Publication Details: Archives of general psychiatry, Vol.67(2), pp.187-196
DOI: 10.1001/archgenpsychiatry.2009.185
PMID: 20124118
PMCID: PMC3718472
NLM abbreviation: Arch Gen Psychiatry
ISSN: 0003-990X
eISSN: 1538-3636
Publisher: American Medical Association; United States
Grant note: R01 MH065134 / NIMH NIH HHS R01 MH-65134 / NIMH NIH HHS
Language: English
Date published: 02/2010
Academic Unit: Neurology; Psychiatry; Iowa Neuroscience Institute; Medicine Administration
Record Identifier: 9984003467802771

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