Post-stroke Depression Treatment Effect on Stroke Recurrence

Study Overview
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Brief Summary
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It is not clear whether depresssion can predispose, or precipitate stroke recurrence in patients with stroke. We sought the relationship of post stroke depression with stroke recurrence.

Detailed Description
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A large body of evidence suggests that depression is associated with a increased risk of many chronic diseases, including hypertension, diabetes, stroke and particularly coronary heart disease. Post stroke depression (PSD) may develop as a result of vascular disease. A previous meta-analysis showed that depression significantly increased the risk of development of stroke, and this increase was probably independent of other risk factors, including hypertension and diabetes. Clarifying this issue has important implications; if depression increases the risk of development of recurrent stroke, so treating PSD might decrease the occurrence of recurrent stroke. To our knowledge there is no study attempting to clarify the relationship between PSD treatment and stroke recurrence. To fill these gap, we systematically conducted a study to assess whether PSD is associated with recurrent stroke, cardiovascular events or death. Thus, in the current study, three different arms of follow-up of patients with first-ever stroke, were used to predict the outcome over 52 weeks.

Official Title
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Impact of Pots-stroke Depression Treatment on Stroke Recurrence

Conditions
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Stroke Recurrence, Cardiovascular Events, Depression

Intervention / Treatment
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* Drug: Citalopram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Patients who met DSM-IV and V criteria for depression Exclusion Criteria: Severe or unstable medical disorders (eg, myocardial infarction within past 3 months, end-stage cancer, decompensated cardiac failure) Known primary neurological disorders including dementia, delirium, Parkinson disease, brain tumors, multiple sclerosis, seizure disorder Drugs (eg, systemic steroids) Pancreatic cancer, uncorrected hypothyroidism Current suicidal risk Use of psychotropic prescription or nonprescription drugs, certain hypnotics Mini-Mental State Examination (MMSE) score of 21 or lower
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Three-site, prospective, nonrandomized controlled trial.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Patients without depression<br>This group included patients without depression during enrollment of the cases. | |
| Experimental: Depressive patients with treatment<br>This group included patients wit depression but with treatment during enrollment of the cases. | Drug: Citalopram<br>* Antidepressant use in patients with depression<br>* Other names: Nontreatment group;|
| No Intervention: Depressive patients wihout treatment<br>This group included patients without depression but withou treatment during enrollment of the cases. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke recurrence | Standard World Health Organization definitions were used for recurrent stroke | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular Event | Cardiovascular events were defined and recorded over the study period if they had at least one of the following: myocardial infarction; unstable angina; angina; percutaneous coronary intervention; or coronary artery bypass graft surgery. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Treatment, Stroke, Myocardial infarction