Tiller J W
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria, Australia.
Psychopharmacology (Berl). 1992;106 Suppl:S130-3. doi: 10.1007/BF02246257.
Depression is present in 25-30% of stroke patients: though associated with physical disability and loss of function, it cannot be explained simply as a response to the disability. The severity of depression correlates with proximity of the lesion to the left anterior frontal pole, while right hemisphere lesions show the reverse trend. Post-stroke depressions may last more than 7-8 months without treatment, and are highly correlated with a failure to resume premorbid social and physical activities. However, this is a group of patients whose recovery could be hastened by appropriate antidepressant treatment, though most antidepressants are of limited value in the treatment of these patients, because of side-effects or possible toxicity. Since moclobemide has few side-effects it may be uniquely well tolerated in this group of patients, having proven efficacy for both endogenous and reactive depressions.
25%至30%的中风患者存在抑郁症状:尽管抑郁与身体残疾和功能丧失有关,但不能简单地将其解释为对残疾的反应。抑郁的严重程度与病变部位靠近左前额叶极的程度相关,而右半球病变则呈现相反趋势。中风后抑郁若不治疗可能持续超过7至8个月,且与无法恢复病前的社交和身体活动密切相关。然而,这是一组通过适当的抗抑郁治疗可以加速康复的患者,尽管大多数抗抑郁药在治疗这些患者时价值有限,因为存在副作用或可能的毒性。由于吗氯贝胺副作用较少,在这组患者中可能具有独特的良好耐受性,已证明其对内源性和反应性抑郁均有效。