Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark.
CNS Drugs. 2018 Oct;32(10):895-903. doi: 10.1007/s40263-018-0573-x.
The great advances in acute stroke treatment during the last decades have changed life after stroke considerably. However, the use of intravenous thrombolysis and endovascular thrombectomy is limited by a relatively narrow time window or contraindications for treatment. Further, patients receiving acute reperfusion therapies may still have cognitive and emotional complications due to underlying brain infarcts even though physical problems may almost disappear. Consequently, stroke is still a frequent cause of adult disability and death worldwide, and an effort to identify additional treatments to enhance recovery, preferably also feasible in the time after the acute phase, is warranted. Albeit several drugs and treatment modalities have been studied for their potential to enhance recovery after stroke, no treatment has unambiguously proven to potentiate the rehabilitation process. A promising candidate for pharmacological treatment is selective serotonin reuptake inhibitors (SSRIs), a group of commonly used antidepressants that may also possess neuro-regenerative properties. The current paper reviews the evidence for SSRIs as potential enhancers of stroke recovery and discusses the potential mechanisms behind the effects reported and the implications for the management of patients post-stoke, including potential adverse events and drug-drug interactions.
在过去几十年中，急性中风治疗的巨大进展极大地改变了中风后的生活。然而，静脉溶栓和血管内血栓切除术的应用受到相对较窄的时间窗口或治疗禁忌的限制。此外，即使身体问题几乎消失，接受急性再灌注治疗的患者仍可能因潜在的脑梗死而出现认知和情感并发症。因此，中风仍然是全世界成人残疾和死亡的常见原因，有必要努力寻找其他治疗方法来增强恢复能力，最好在急性阶段后也能实现。尽管已经研究了几种药物和治疗方式，以评估它们在中风后恢复方面的潜力，但没有一种治疗方法明确证明可以增强康复过程。一种有前途的药物治疗候选物是选择性 5-羟色胺再摄取抑制剂（SSRIs），这是一组常用的抗抑郁药，可能也具有神经再生特性。本文综述了 SSRIs 作为潜在增强中风恢复的药物的证据，并讨论了报告的作用背后的潜在机制以及对中风后患者管理的影响，包括潜在的不良反应和药物相互作用。
