Is it safe to use antidepressants after a stroke?

Depression is an important complication of stroke. Although antidepressants are widely used for the treatment of poststroke depression ( PSD ), prescription is critically influenced by their safety, tolerability and by the impact on co-morbidities. The authors veriewed the literature on the use of antidepressants after stroke. Selective serotonin re-aptake inhibitors are effective and have a good profile of safety and tolerability in PSD. They are, therefore, used as first-line drugs in the treatment of PSD, although potential cardiovascular and cerebrovascular effects, drug-drug interactions and intolerability in a minority of patients have to be considered. Other antipressants appear to be safe and effective in selected patients. PSD patients should be classified according to their clinical profile for the selection of the drug of choise in particular subgroups of patients.

La depressione rappresenta una frequente complicazione degli eventi cerebrovascolari ictali con importanti ricadute cliniche ed evolutive. La presente review passa in rassegna le varie possibilità terapeutiche con valutazione di indicazioni, controindicazioni, effetti collaterali delle varie opzioni terapeutiche, incluse la possibilità di associazioni per una più migliore risposta terapeutica sulla scorta della predittività della sensibilità farmacologica suggerita dalla sintomatologia del paziente.