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Antidepressants Improve Post-Stroke Mental Abilities

signed (with the exception of those with certain medical conditions) to take the antidepressant fluoxetine (Prozac), the antidepressant nortriptyline (Aventyl or Pamelor) or a placebo (inactive substance).

Their executive functions were assessed using standard neuropsychological tasks at the end of 12 weeks of treatment, and again two years after the study had started. A total of 36 patients completed all the evaluations.

No significant differences were found between the antidepressant and placebo groups at the end of treatment. However, 21 months after the treatment ended, the placebo group showed continued worsening of the executive functions, whereas the group treated with antidepressants had clear and significant improvement, regardless of how their depressive symptoms changed.

"We were somewhat surprised to initially not find any difference after the first 12 weeks of treatment. It took another 21 months after the initial treatments for the antidepressants to have a detectable effect," Paradiso said.

The investigators hypothesize that antidepressants may foster recovery of neural tissue not directly destroyed by the stroke, yet because the process is slow, it takes months.

"Drugs such as antibiotics start working right away to kill germs. However, antidepressants may be reorganizing brain structure and re-establishing neuronal connections that were lost because of the death of neurons due to the stroke," Paradiso said. "We expect this regeneration to happen in longer, rather than brief, periods of time.

"We really appreciate the patients who made the commitment to participate in this two-year-long study while they were in their post-stroke recovery. The information we've learned will help us develop new studies," he added.

The researchers plan to examine individuals who responded favorably to the antidepressants and look noninvasively for brain changes.

"We can do fu
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