Efficacy and Safety of Citalopram in Treating Post-Stroke Depression: A Meta-Analysis

Tan, Shuai; Huang, Xinyi; Ding, Lei; Hong, Ha-Cheol

doi:10.1159/000441446

Cited by 19 publications

(8 citation statements)

References 13 publications

(11 reference statements)

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“…Conventional pairwise meta-analyses of the treatment of antidepressants in PSD were less, 7 48–52 few of which conducted meta-analysis based on different antidepressants. Tan et al 48 showed that citalopram was superior to the other SSRIs and TCAs in improving the total HDRS scores of PSD with acute treatment. The only other SSRIs included in that study were fluoxetine and sertraline.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis

et al. 2017

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ObjectiveThe aim of this study is to create a rank order of the comparative efficacy and acceptability (risk of all-cause discontinuation) of antidepressant treatment in poststroke depression (PSD) by integrating direct and indirect evidence.DesignMultiple-treatments meta-analysis of randomised controlled trials.ParticipantsPatients with depression following stroke.Interventions10 antidepressants and placebo in the acute treatment of PSD.Outcome measuresThe primary outcomes were the overall efficacy, defined as the mean change of the total depression score. The secondary outcome was the acceptability, defined as risk of all-cause discontinuation. These estimates as standardised mean differences or ORs with 95% CIs.ResultsWe identified 12 suitable trials, with data from 707 participants. All drugs were significantly more effective than placebo apart from sertraline, nefiracetam and fluoxetine. Most of the comparisons for acceptability revealed no significant differences except that paroxetine had significantly lower all-cause discontinuation than doxepin, citalopram and fluoxetine. Standardised mean differences compared with placebo for efficacy varied from −6.54 for the best drug (reboxetine) to 0.51 for the worst drug (nefiracetam). ORs compared with placebo for acceptability ranged from 0.09 for the best drug (paroxetine) to 3.42 for the worst drug (citalopram). For the efficacy rank, reboxetine, paroxetine, doxepin and duloxetine were among the most efficacious treatments, the cumulative probabilities of which were 100%, 85.7%, 83.2%, 62.4%, respectively. With respect to the acceptability rank, paroxetine, placebo, sertraline and nortriptyline were among the most acceptable treatments, the cumulative probabilities of which were 92.4%, 63.5%, 57.3%, 56.3%.ConclusionAfter weighing the efficacy and acceptability, we conclude that paroxetine might be the best choice when starting acute treatment for PSD, and fluoxetine might be the worst choice.Trial registration numberThis systematic review has been registered in the Prospective Register of Systematic Review Protocols (PROSPERO) public database (CRD42017054741; http://www.crd.york.ac.uk/PROSPERO).

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Section: Discussionmentioning

confidence: 99%

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis

et al. 2017

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“…An open-label study [ 55 ] among stroke survivors with depression found that symptoms of depression and anxiety had consistent decline along with improvement in cognitive and functional performances with sertraline treatment and hence findings from this study are unsurprising. Approximately 14% of the current study sample reported using citalopram, which can be explained in the light of fewer side effects observed with citalopram in stroke survivors with depression [ 56 ], as well as the chances of significantly improving dexterity [ 57 ] after stroke. However, use of some individual antidepressants such as trazodone, mirtazapine and venlafaxine warrants constant monitoring as they have been observed to be associated high risks of several adverse events [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, patterns and predictors of depression treatment among community-dwelling older adults with stroke in the United States: a cross sectional study

et al. 2018

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BackgroundDepression is one of the most common psychiatric conditions among stroke survivors and is associated with several negative health outcomes. However, little is known about the depression treatment patterns among stroke survivors. The objective of this study was to examine national-level prevalence, patterns and predictors of depression treatment among community-dwelling stroke survivors.MethodsThis study adopted a retrospective, cross-sectional study design using multiple years of Medical Expenditure Panel Survey (MEPS) (2002–2012) data. The study population consisted of older adults (age ≥ 50 years) who (i) were stroke survivors (ICD-9-CM codes of 430–438), (ii) did not die during the calendar year, and (iii) had co-occurring depression (ICD-9-CM code of 296.xx, or 311.xx). Depression treatment, identified by antidepressant medication and/or psychotherapy use, was the dependent variable of this study. Multinomial logistic regression analysis was conducted to examine the association of individual level factors with depression treatment among stroke survivors with co-occurring depression.ResultsThe final study sample consisted 370 (unweighted) community-dwelling older adults with self-reported stroke and depression. The prevalence of co-occurring depression among stroke survivors was 22.03% [95% Confidence Interval (CI) 19.7–24.4%]. An overwhelming majority (87.6%) of stroke survivors with co-occurring depression reported some form of depression treatment. Antidepressants only and combination therapy was reported by 74.8% (95% CI, 71.6–78.0%] and 12.8% (95% CI, 10.5–15.1%) by stroke survivors with co-occurring depression respectively. Approximately, 61% of stroke survivors with co-occurring depression reported using SSRIs, followed by SNRIs (15.2%), miscellaneous antidepressants (12.1%), TCAs (9.8%), phenylpiperazine antidepressants (5.2%), and tetracyclic antidepressants (4%). Sertraline (15.8, 95% CI, 12.7–19.0%) had the highest reported use among individual antidepressants.ConclusionsVast majority (nearly 90%) of the study sample received some form of depression treatment and several individual level factors (such as age, education) were associated with the report of depression treatment use. Future longitudinal studies are warranted to assess the comparative treatment benefits of antidepressants, psychotherapy and their combination. Healthcare providers should carefully assess the risks and benefits of antidepressant (such as SSRIs or TCAs) use in this vulnerable population prior to their use.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1723-x) contains supplementary material, which is available to authorized users.

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“…Nowadays, there are at least 6 SSRI drugs (fluoxetine, paroxetine, fluvoxamine, sertraline, citalopram, and escitalopram) and 3 SNRI drugs (i.e., milnacipran, duloxetine, and duloxetine) available in PSD treatment. Anyway, a series of studies have shown that the SSRI drugs also had great effects on PSD treatment ( 99 – 105 ), such as gastrointestinal symptoms, headache, sexual dysfunction, and insomnia ( 7 ).…”

Section: Monoamine Transmitters In the Treatment Of Psdmentioning

confidence: 99%

The Relationship Between 5-Hydroxytryptamine and Its Metabolite Changes With Post-stroke Depression

Zheng-ming

et al. 2022

Front. Psychiatry

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Post-stroke depression (PSD) is the most common and serious sequelae of stroke. Approximately 33% of stroke survivors were affected by PSD. However, many issues (e.g., incidence, diagnostic marker, and risk factor) related to PSD remained unclear. The “monoamine hypothesis” is a significant hypothesis for depression, which suggests that three monoamines play a key role in depression. Therefore, most current antidepressants are developed to modulate the monoamines on PSD treatment, and these antidepressants have good effects on patients with PSD. However, the potential mechanisms of three monoamines in PSD are still unclear. Previously, we proposed “three primary emotions,” which suggested a new model of basic emotions based on the three monoamines. It may provide a new way for PSD treatment. In addition, recent studies have found that monoamine-related emotional intervention also showed potential effects in the treatment and prevention of PSD. This study discusses these issues and attempts to provide a prospect for future research on PSD.

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Efficacy and Safety of Citalopram in Treating Post-Stroke Depression: A Meta-Analysis

Cited by 19 publications

References 13 publications

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: a multiple-treatments meta-analysis

Prevalence, patterns and predictors of depression treatment among community-dwelling older adults with stroke in the United States: a cross sectional study

The Relationship Between 5-Hydroxytryptamine and Its Metabolite Changes With Post-stroke Depression

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