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Escitalopram may improve some cognitive functions after stroke in non-depressed patients

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Question

Question:

Does the selective serotonin reuptake inhibitor escitalopram enhance performance on neuropsychological tests assessing memory and executive functions after stroke?

Patients:

129 nondepressed patients aged between 50 and 90 years with cerebral hemisphere, brainstem or cerebellar ischemic or haemorraghic stroke. Patients were randomised within 3 months of an index stroke.

Setting:

University of Iowa Stroke Center, USA; 2003 and 2007.

Intervention:

Escitalopram versus placebo or problem-solving therapy (PST). Escitalopram was given at a dose of 10mg, once daily, for patients aged < 65 years and 5 mg for patients aged ≥ 65 years. The placebo and PST groups were pooled for the main analyses, as the focus of the study was the effect of escitalopram.

Outcomes:

Change from baseline status in cognitive function was assessed using a range of tests: immediate memory, visuospatial constructional, language, attention and delayed memory (Repeatable Battery for the Assessment of Neuropsychological Status, RBANS); psychomotor processing speed and cognitive flexibility (Trail-making test parts A and B); verbal fluency (Controlled Oral Word Association test); abstract thinking (Wechsler Adult Intelligence Scale-III Similarities test); attention and response inhibition …

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