Sivolap Yu P, Damulin I V
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(9):143-147. doi: 10.17116/jnevro2019119091143.
Depression is a frequent complication of stroke and occurs in approximately one in three surviving patients. Depression worsens the course of post-stroke neurological disorders, enhances the physical helplessness of patients, further reduces their quality of life, significantly decreases the effectiveness of therapeutic and rehabilitation measures and increases the risk of death. Antidepressants eliminate or relieve depressive symptoms, mitigate neurological disorders, improve cognitive functions and the general condition of patients, increase the effectiveness of treatment and rehabilitation, diminish the risk of recurrent stroke and decrease mortality. Selective serotonin reuptake inhibitors are the first line antidepressants for post-stroke patients; there is evidence of the effectiveness of other modern antidepressants, as well as tricyclic drugs. Unresolved aspects of this problem that require further well-designed controlled studies include tolerability of antidepressants by patients of late age, the choice of optimal drugs and the duration of therapy.
抑郁症是中风常见的并发症,约三分之一的幸存患者会出现。抑郁症会使中风后神经功能障碍的病程恶化,加重患者身体上的无助感,进一步降低其生活质量,显著降低治疗和康复措施的效果,并增加死亡风险。抗抑郁药可消除或缓解抑郁症状,减轻神经功能障碍,改善患者的认知功能和总体状况,提高治疗和康复效果,降低中风复发风险并降低死亡率。选择性5-羟色胺再摄取抑制剂是中风后患者的一线抗抑郁药;有证据表明其他现代抗抑郁药以及三环类药物也有效。该问题尚未解决的方面,包括老年患者对抗抑郁药的耐受性、最佳药物的选择以及治疗持续时间等,需要进一步精心设计的对照研究。