Monday, January 21, 2008

Stroke and Depression: Frequently Asked Questions

Stroke and Depression: Frequently Asked Questions
Robert Robinson, MD
Division of Psychiatry
University of Iowa Hospitals and Clinics

Creation Date: June 2000
Last Revision Date: December 2004
Peer Review Status: Internally Peer Reviewed

Some facts: there are approximately 500,000 strokes that occur in the United States. Of those strokes, about 70 to 80 percent of patients survive the stroke. Of those patients who survive the stroke, depression occurs in approximately 40 to 50 percent of patients. Major depression occurs in about 20 percent of patients. Major depression is the most severe form of clinical depression that we recognize in neuropsychiatry. Another, about 20 percent of patients, will develop minor depression. There are some, approximately 10 to 20 percent of patients, who develop either major or minor depression some months or even a year after the onset of the stroke. Most depressions occur within the acute period after the stroke, but there are some depressions, that are delayed in onset and occur during the first year of poststroke recovery. The issue of poststroke depression has gained worldwide interest in the past 10 years. There has been a general agreement about the prevalence of both major and minor depression after stroke. Depression is one of the major impediments to full physical and mental recovery from stroke.

Do most stroke sufferers end up suffering depression?

Approximately 50 percent will become depressed at some time during the first two years after the stroke. The majority of patients, approximately 40 percent, will develop depression within the first one to two months after the stroke. There is another number of 10 to 20 percent of patients who will develop depression at some later time during the first two years.

What type of rehab can help with stroke depression?

By rehab, I assume what is meant is the usual types of rehabilitation therapy such as physical therapy, speech therapy, and occupational therapy. These do not specifically treat depression after a stroke. The treatment for poststroke depression that has received the most scientific study has been the use of antidepressant medications. Both Nortriptyline and Citalopram have been demonstrated in controlled studies to be effective in treating poststroke depression.


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