Trazodone therapy of the post-stroke depression

The incidence of depression following a hemispheric stroke ranges from 25 to 60 %. The benefit of antidepressant therapy on the outcome of rehabilitation in the subacute post-stroke phase is well known. We studied subjects both with and without evidence of depression, as indicated by any one of three criteria: (i) Clinical diagnosis of depression, (ii) Abnormal Zung-depression score, (iii) Abnormal dexamethasone suppression test (DST). Patients in a stroke rehabili-tation program (22) were randomized to receive either placebo or 300 mg/day trazodone-HCI, beginning 30 days after the stroke. Patients with either a clinical diagnosis of depression or abnormal Zung depression scores showed a consistent trend towards greater improvement in Barthel activities of daily living (ADL) scores, with antidepressant therapy, as compared to patients receiving placebo. An abnormal DST was associated with significant improvement in the ADL scores in subjects receiving trazodone, i.e., in post-stroke depression such a treatment seems to be beneficial