Journal article
Prevention of Poststroke Apathy Using Escitalopram or Problem-Solving Therapy
The American journal of geriatric psychiatry, Vol.21(9), pp.855-862
09/01/2013
DOI: 10.1016/j.jagp.2012.07.003
PMID: 23930743
Abstract
Objective: Apathy occurs frequently following stroke and prior studies have demonstrated the negative effect of apathy on recovery from stroke. This study was a secondary analysis examining the efficacy of escitalopram, problem-solving therapy (PST), or placebo administered for 1 year to prevent the onset of apathy among patients with recent stroke. Methods: Patients within 3 months of an index stroke who did not meet DSM-IV diagnostic criteria for major or minor depression and who did not have a serious comorbid physical illness were enrolled. Patients were recruited from three sites: University of Iowa, University of Chicago, and Burke Rehabilitation Hospital. One hundred fifty-four patients without evidence of apathy at initial evaluation were included in the randomized controlled trial using escitalopram (10 mg patients <= 65 years; 5 mg patients >65 years) (N = 51) or placebo (N = 47) or non-blinded PST (12 total sessions) (N = 56) over 1 year. At 3, 6, 9, and 12 months, patients were assessed for diagnosis and severity of apathy using the Apathy Scale. Results: Using a Cox proportional hazards model of time to onset of apathy, participants given placebo were 3.47 times more likely to develop apathy than patients given escitalopram and 1.84 times more likely to develop apathy than patients given PST after controlling for age, sex, cognitive impairment, and diabetes mellitus status (adjusted hazard ratio: 3.47, 95% CI: 1.79-673 [escitalopram group]; adjusted hazard ratio: 1.84, 95% CI: 1.21-2.80 [PST group]). Conclusion: Escitalopram or PST was significantly more effective in preventing new onset of apathy following stroke compared with placebo.
Details
- Title: Subtitle
- Prevention of Poststroke Apathy Using Escitalopram or Problem-Solving Therapy
- Creators
- Katsunaka Mikami - Tokai UniversityRicardo E. Jorge - Roy J. and Lucille A. Carver College of MedicineDavid J. Moser - Roy J. and Lucille A. Carver College of MedicineStephan Arndt - Roy J. and Lucille A. Carver College of MedicineMijin Jang - Roy J. and Lucille A. Carver College of MedicineAna Solodkin - University of California, IrvineSteven L. Small - University of California, IrvinePasquale Fonzetti - Burke Rehabilitation HospitalMark T. Hegel - Dartmouth–Hitchcock Medical CenterRobert G. Robinson - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- The American journal of geriatric psychiatry, Vol.21(9), pp.855-862
- DOI
- 10.1016/j.jagp.2012.07.003
- PMID
- 23930743
- NLM abbreviation
- Am J Geriatr Psychiatry
- ISSN
- 1064-7481
- eISSN
- 1545-7214
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- R01DC007488 / NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD) R01 MH 065134 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA R01MH065134 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Tokai University, Kanagawa, Japan
- Language
- English
- Date published
- 09/01/2013
- Academic Unit
- Psychiatry; Biostatistics; Nursing; Injury Prevention Research Center; Medicine Administration
- Record Identifier
- 9984280844002771
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