Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review

Warunya Woranush,1,2 Mats Leif Moskopp,2,3 Annahita Sedghi,1 Isabella Stuckart,1 Thomas Noll,2 Kristian Barlinn,1 Timo Siepmann1 1Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 2Institute of Physiology, Medical Faculty Carl Gustav Ca...

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Autores principales:	Woranush W, Moskopp ML, Sedghi A, Stuckart I, Noll T, Barlinn K, Siepmann T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	psd antidepressant depression prevention stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/c4e0ae2a27de44c5bedcd2ef9296a340
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spelling	oai:doaj.org-article:c4e0ae2a27de44c5bedcd2ef9296a3402021-11-18T19:40:26ZPreventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review1178-2021https://doaj.org/article/c4e0ae2a27de44c5bedcd2ef9296a3402021-11-01T00:00:00Zhttps://www.dovepress.com/preventive-approaches-for-post-stroke-depression-where-do-we-stand-a-s-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Warunya Woranush,1,2 Mats Leif Moskopp,2,3 Annahita Sedghi,1 Isabella Stuckart,1 Thomas Noll,2 Kristian Barlinn,1 Timo Siepmann1 1Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 2Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 3Vivantes Klinikum im Friedrichshain, Charité Academic Teaching Hospital, Klinik für Neurochirurgie, Berlin, GermanyCorrespondence: Timo SiepmannDepartment of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetschertstr. 74, Dresden, 01309, GermanyTel +49 175-613-14546Email timo.siepmann@ukdd.dePurpose: Post-stroke depression (PSD) occurs in one-third of stroke survivors, leading to a substantial decrease in quality of life as well as delayed functional and neurological recovery. Early detection of patients at risk and initiation of tailored preventive measures may reduce the medical and socioeconomic burden associated with PSD. We sought to review the current evidence on pharmacological and non-pharmacological prevention of PSD.Materials and Methods: We conducted a systematic review using PubMed/MEDLINE and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including randomized controlled studies. Eligible studies were included when performed within 1 year after the index cerebrovascular event. Animal and basic research studies, studies lacking a control group, review papers, and case reports were excluded.Results: Out of 150 studies screened, 37 met our criteria. Among the strategies identified, administration of antidepressants displayed the most robust evidence for preventing PSD, whereas non-pharmacological interventions such as psychotherapy appear to be the most frequently used approaches to prevent depression after stroke. Research suggests that the efficacy of PSD prevention increases with the duration of preventive treatment. Seven out of 11 studies (63%) that used pharmacological and eight out of 16 (50%) that used non-pharmacological interventions reported a positive preventive effect on PSD.Conclusion: Overall, the current literature on PSD prevention shows heterogeneity, substantiating a need for well-designed randomized controlled trials to test the safety and efficacy of pharmacological as well as non-pharmacological and composite prevention regimens to minimize the risk of PSD in stroke survivors. Integrative strategies combining personalized non-pharmacological interventions such as educational, mental, and physical health support, and pharmacological strategies such as SSRIs may be the most promising approach to prevent PSD.Keywords: PSD, antidepressant, depression, prevention, strokeWoranush WMoskopp MLSedghi AStuckart INoll TBarlinn KSiepmann TDove Medical PressarticlepsdantidepressantdepressionpreventionstrokeNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 3359-3377 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	psd antidepressant depression prevention stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	psd antidepressant depression prevention stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Woranush W Moskopp ML Sedghi A Stuckart I Noll T Barlinn K Siepmann T Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
description	Warunya Woranush,1,2 Mats Leif Moskopp,2,3 Annahita Sedghi,1 Isabella Stuckart,1 Thomas Noll,2 Kristian Barlinn,1 Timo Siepmann1 1Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 2Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 3Vivantes Klinikum im Friedrichshain, Charité Academic Teaching Hospital, Klinik für Neurochirurgie, Berlin, GermanyCorrespondence: Timo SiepmannDepartment of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetschertstr. 74, Dresden, 01309, GermanyTel +49 175-613-14546Email timo.siepmann@ukdd.dePurpose: Post-stroke depression (PSD) occurs in one-third of stroke survivors, leading to a substantial decrease in quality of life as well as delayed functional and neurological recovery. Early detection of patients at risk and initiation of tailored preventive measures may reduce the medical and socioeconomic burden associated with PSD. We sought to review the current evidence on pharmacological and non-pharmacological prevention of PSD.Materials and Methods: We conducted a systematic review using PubMed/MEDLINE and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including randomized controlled studies. Eligible studies were included when performed within 1 year after the index cerebrovascular event. Animal and basic research studies, studies lacking a control group, review papers, and case reports were excluded.Results: Out of 150 studies screened, 37 met our criteria. Among the strategies identified, administration of antidepressants displayed the most robust evidence for preventing PSD, whereas non-pharmacological interventions such as psychotherapy appear to be the most frequently used approaches to prevent depression after stroke. Research suggests that the efficacy of PSD prevention increases with the duration of preventive treatment. Seven out of 11 studies (63%) that used pharmacological and eight out of 16 (50%) that used non-pharmacological interventions reported a positive preventive effect on PSD.Conclusion: Overall, the current literature on PSD prevention shows heterogeneity, substantiating a need for well-designed randomized controlled trials to test the safety and efficacy of pharmacological as well as non-pharmacological and composite prevention regimens to minimize the risk of PSD in stroke survivors. Integrative strategies combining personalized non-pharmacological interventions such as educational, mental, and physical health support, and pharmacological strategies such as SSRIs may be the most promising approach to prevent PSD.Keywords: PSD, antidepressant, depression, prevention, stroke
format	article
author	Woranush W Moskopp ML Sedghi A Stuckart I Noll T Barlinn K Siepmann T
author_facet	Woranush W Moskopp ML Sedghi A Stuckart I Noll T Barlinn K Siepmann T
author_sort	Woranush W
title	Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
title_short	Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
title_full	Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
title_fullStr	Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
title_full_unstemmed	Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review
title_sort	preventive approaches for post-stroke depression: where do we stand? a systematic review
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/c4e0ae2a27de44c5bedcd2ef9296a340
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Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review

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