Fortschr Neurol Psychiatr 2023; 91(12): 510-515
DOI: 10.1055/a-2190-9141
Übersichtsarbeit

Prävention der Post-Stroke-Depression

Prevention of Post-Stroke Depression
Erik Simon
1   Klinik und Poliklinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus, Dresden, Germany
,
Kristian Barlinn
1   Klinik und Poliklinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus, Dresden, Germany
,
Timo Siepmann
1   Klinik und Poliklinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus, Dresden, Germany
› Author Affiliations

Zusammenfassung

Die Post-Stroke-Depression (PSD) ist eine klinisch relevante nicht-motorische Komplikation ischämischer und hämorrhagischer Hirninfarkte, die etwa 30% aller Schlaganfallpatient:innen betrifft. Sie geht neben einer Beeinträchtigung der Lebensqualität auch mit einer Verzögerung der Rekonvaleszenz schlaganfallbezogener neurologischer und funktioneller Defizite einher und vermag so, den Rehabilitationsverlauf ungünstig zu beeinflussen. Durch geeignete Screeningverfahren kann die PSD frühzeitig erkannt werden. Neben der zeitnahen Einleitung der Behandlung einer manifestierten PSD kann insbesondere auch die Implementierung effektiver Maßnahmen der Prävention zu einer Reduktion der mit einer PSD vergesellschafteten medizinischen und sozioökonomischen Belastungen führen. Diese Übersichtsarbeit fasst die aktuelle Literatur zur medikamentösen und nichtmedikamentösen PSD Prävention bei Schlaganfallpatient:innen zusammen.

Abstract

Post-stroke depression (PSD) is a clinically relevant complication of ischemic and hemorrhagic cerebral infarction that affects about 30% of all stroke survivors. It is associated with reduced quality of life as well as delayed recovery from neurological deficits and functional impairment, frequently leading to impeded rehabilitation. Suitable screening methods allow early detection of PSD. Timely initiation of treatment in patients with manifest PSD as well as implantation of effective prevention strategies can help reduce medical and socioeconomic burden associated with the disease. We reviewed the current literature on pharmacological and non-pharmacological prevention of PSD.



Publication History

Received: 11 July 2023

Accepted: 19 October 2023

Article published online:
11 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. The Lancet. Neurology 2007; 6: 182-187 DOI: 10.1016/S1474-4422(07)70031-5.
  • 2 Die Berliner Akuter Schlaganfall Studie. Nolte CH, Jungehülsing GJ, Müller-Nordhorn J, Rossnagel K, Roll S, Willich SN, Villringer A. Schwachstellen und Verbesserungsmöglichkeiten in der Versorgung von Patienten mit akutem Schlaganfall. Nervenheilkunde 2006; 25: 901-905
  • 3 Robinson RG, Starr LB, Kubos KL, Price TR. A two-year longitudinal study of post-stroke mood disorders: findings during the initial evaluation. Stroke 1983; 14: 736-741 DOI: 10.1161/01.str.14.5.736.
  • 4 Jaracz K, Jaracz J, Kozubski W, Rybakowski JK. Post-stroke quality of life and depression. Acta neuropsychiatrica 2002; 14: 219-225 DOI: 10.1034/j.1601-5215.2002.140504.x.
  • 5 Husaini B, Levine R, Sharp L, Cain V, Novotny M, Hull P, Orum G, Samad Z, Sampson U, Moonis M. Depression increases stroke hospitalization cost: an analysis of 17,010 stroke patients in 2008 by race and gender. Stroke research and treatment 2013; 2013: 846732 DOI: 10.1155/2013/846732.
  • 6 Shi Y, Yang D, Zeng Y, Wu W. Risk Factors for Post-stroke Depression: A Meta-analysis. Frontiers in aging neuroscience 2017; 9: 218 DOI: 10.3389/fnagi.2017.00218.
  • 7 Folstein MF, Maiberger R, McHugh PR. Mood disorder as a specific complication of stroke. Journal of neurology, neurosurgery, and psychiatry 1977; 40: 1018-1020 DOI: 10.1136/jnnp.40.10.1018.
  • 8 Sun Y, Liang Y, Jiao Y, Lin J, Qu H, Xu J, Zhao C. Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis. BMJ open 2017; 7: e016499 DOI: 10.1136/bmjopen-2017-016499.
  • 9 Niedermaier N, Bohrer E, Schulte K, Schlattmann P, Heuser I. Prevention and treatment of poststroke depression with mirtazapine in patients with acute stroke. The Journal of clinical psychiatry 2004; 65: 1619-1623 DOI: 10.4088/jcp.v65n1206.
  • 10 Tsai CS, Wu CL, Chou SY, Tsang HY, Hung TH, Su JA. Prevention of poststroke depression with milnacipran in patients with acute ischemic stroke: a double-blind randomized placebo-controlled trial. International clinical psychopharmacology 2011; 26: 263-267 DOI: 10.1097/YIC.0b013e32834a5c64.
  • 11 Rasmussen A, Lunde M, Poulsen DL, Sørensen K, Qvitzau S, Bech P. A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Psychosomatics 2003; 44: 216-221 DOI: 10.1176/appi.psy.44.3.216.
  • 12 FOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet (London, England) 2019; 393: 265-274 DOI: 10.1016/S0140-6736(18)32823-X.
  • 13 EFFECTS Trial Collaboration. Safety and efficacy of fluoxetine on functional recovery after acute stroke (EFFECTS): a randomised, double-blind, placebo-controlled trial. The Lancet. Neurology 2020; 19: 661-669 DOI: 10.1016/S1474-4422(20)30219-2.
  • 14 AFFINITY Trial Collaboration. Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial. The Lancet. Neurology 2020; 19: 651-660 DOI: 10.1016/S1474-4422(20)30207-6.
  • 15 Almeida OP, Waterreus A, Hankey GJ. Preventing depression after stroke: Results from a randomized placebo-controlled trial. The Journal of clinical psychiatry 2006; 67: 1104-1109 DOI: 10.4088/jcp.v67n0713.
  • 16 Stuckart I, Siepmann T, Hartmann C, Pallesen LP, Sedghi A, Barlinn J, Reichmann H, Puetz V, Barlinn K. Sertraline for Functional Recovery After Acute Ischemic Stroke: A Prospective Observational Study. Frontiers in neurology 2021; 12: 734170 DOI: 10.3389/fneur.2021.734170.
  • 17 EMOTION investigators. Kim JS, Lee EJ, Chang DI. et al. Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study. The lancet. Psychiatry 2017; 4: 33-41 DOI: 10.1016/S2215-0366(16)30417-5.
  • 18 Palomäki H, Kaste M, Berg A, Lönnqvist R, Lönnqvist J, Lehtihalmes M, Hares J. Prevention of poststroke depression: 1 year randomised placebo controlled double blind trial of mianserin with 6 month follow up after therapy. Journal of neurology, neurosurgery, and psychiatry 1999; 66: 490-494 DOI: 10.1136/jnnp.66.4.49020.
  • 19 Siepmann T, Penzlin AI, Kepplinger J, Illigens BM, Weidner K, Reichmann H, Barlinn K. Selective serotonin reuptake inhibitors to improve outcome in acute ischemic stroke: possible mechanisms and clinical evidence. Brain Behav 2015; 5: e00373 DOI: 10.1002/brb3.373.. PMID: 26516608PMCID: PMC4614057.
  • 20 Cao JX, Liu L, Sun YT, Zeng QH, Wang Y, Chen JC. Effects of the prophylactic use of escitalopram on the prognosis and the plasma copeptin level in patients with acute cerebral infarction. Brazilian journal of medical and biological research=Revista brasileira de pesquisas medicas e biologicas 2020; 53: e8930 DOI: 10.1590/1414-431X20208930.
  • 21 Faulkner J, McGonigal G, Woolley B, Stoner L, Wong L, Lambrick D. A randomized controlled trial to assess the psychosocial effects of early exercise engagement in patients diagnosed with transient ischaemic attack and mild, non-disabling stroke. Clinical rehabilitation 2015; 29: 783-794 DOI: 10.1177/0269215514555729.
  • 22 Ihle-Hansen H, Thommessen B, Fagerland MW, Oksengård AR, Wyller TB, Engedal K, Fure B. Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: a randomized controlled trial. Aging & mental health 2014; 18: 540-546 DOI: 10.1080/13607863.2013.824406.
  • 23 Jönsson AC, Höglund P, Brizzi M, Pessah-Rasmussen H. Secondary prevention and health promotion after stroke: can it be enhanced?. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2014; 23: 2287-2295 DOI: 10.1016/j.jstrokecerebrovasdis.2014.04.021.
  • 24 HESTIA Study Group. Boter H. Multicenter randomized controlled trial of an outreach nursing support program for recently discharged stroke patients. Stroke 2004; 35: 2867-2872 DOI: 10.1161/01.STR.0000147717.57531.e5.
  • 25 Cheng C, Liu X, Fan W, Bai X, Liu Z. Comprehensive Rehabilitation Training Decreases Cognitive Impairment, Anxiety, and Depression in Poststroke Patients: A Randomized, Controlled Study. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2018; 27: 2613-2622 DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.038.
  • 26 Davis MC. Life review therapy as an intervention to manage depression and enhance life satisfaction in individuals with right hemisphere cerebral vascular accidents. Issues in mental health nursing 2004; 25: 503-515 DOI: 10.1080/01612840490443455.
  • 27 Kang HS, Sok SR, Kang JS. Effects of Meridian acupressure for stroke patients in Korea. Journal of clinical nursing 2009; 18: 2145-2152 DOI: 10.1111/j.1365-2702.2008.02522.x.
  • 28 American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Towfighi A, Ovbiagele B, El Husseini N, Hackett ML, Jorge RE, Kissela BM, Mitchell PH, Skolarus LE, Whooley MA, Williams LS. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2017; 48: e30-e43 DOI: 10.1161/STR.0000000000000113.
  • 29 Fruehwald S, Gatterbauer E, Rehak P, Baumhackl U. Early fluoxetine treatment of post-stroke depression--a three-month double-blind placebo-controlled study with an open-label long-term follow up. Journal of neurology 2003; 250: 347-351 DOI: 10.1007/s00415-003-1014-3.
  • 30 Allida S, Cox KL, Hsieh CF, Lang H, House A, Hackett ML. Pharmacological, psychological, and non-invasive brain stimulation interventions for treating depression after stroke. The Cochrane database of systematic reviews 2020; 1: CD003437 DOI: 10.1002/14651858.CD003437.pub4.