[Skip to Navigation]
Views 3,461
Citations 0
Editorial
August 2, 2021

Poststroke Selective Serotonin Reuptake Inhibitors—Do They Work for Anything?

Author Affiliations
  • 1Department of Clinical Neurosciences (Neurology) and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 3Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 4Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 5Department of Clinical Neurosciences (Physiatry) and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
JAMA Neurol. 2021;78(9):1053-1054. doi:10.1001/jamaneurol.2021.1907

In the community, major risk factors for depression include sex, advancing age, lower income, employment status, and illnesses such as stroke that result in disability and affect income, employment, and social status.1 Poststroke depression affects 1 in every 3 patients in the first year after stroke occurrence and thereafter. Important general treatments for depression include the selective serotonin reuptake inhibitors; these compounds have also been suggested to modulate motor and functional recovery after stroke. The FLAME (Fluoxetine for Motor Recovery After Acute Ischaemic Stroke) trial2 kindled interest in treatment with fluoxetine hydrochloride for stroke motor recovery more than a decade ago, but 3 subsequent randomized trials with much larger sample sizes failed to confirm a significant impact on functional outcomes as measured by the modified Rankin Scale score.3-5 However, the secondary outcome of depression was improved in 2 of those trials,3,5 but not in several prior smaller trials.6-10 In this issue of JAMA Neurology, Almeida and colleagues11 now report on depression outcomes from the AFFINITY (Assessment of Fluoxetine in Stroke Recovery) trial.4

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×