Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Sunday, August 13, 2017

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: A multiple-treatments meta-analysis

What a waste. To me, most of the point of taking anti-depressants is the better recovery you get regardless of if you have depression. As a result more research will need to be done because we have NO fucking stroke strategy at all.

Common antidepressant can help stroke patients improve movement and coordination Sept. 2015 

Antidepressants may help people recover from stroke even if they are not depressed Jan. 2013

Because we have NO stroke leadership and NO stroke strategy we get wastes of money and time for research like this.

Comparative efficacy and acceptability of antidepressant treatment in poststroke depression: A multiple-treatments meta-analysis

BMJ Open
Sun Y, et al.
The objective here was to formulate a rank order of the comparative efficacy and acceptability (risk of all–cause discontinuation) of antidepressant treatment, in poststroke depression (PSD) by integrating direct and indirect evidence. It was discovered that paroxetine could serve as the best choice when starting acute treatment for PSD, and fluoxetine could be the worst choice, after weighing the efficacy and acceptability.

Methods

  • The scheme of this research was a multiple-treatments meta-analysis of randomised controlled trials.
  • The recruitment comprised of patients with depression, following stroke.
  • The intervention constituted 10 antidepressants and placebo in the acute treatment of PSD.
  • The primary outcomes were the overall efficacy, defined as the mean change of the total depression score.
  • The secondary outcome was the acceptability, defined as risk of all-cause discontinuation.
  • These estimates as standardised mean differences or ORs with 95% Cis.

Results

  • 12 suitable trials were determined, with data from 707 participants.
  • All drugs were markedly more effective than placebo apart from sertraline, nefiracetam and fluoxetine.
  • Maximum comparisons for acceptability did not disclose any significant variations.
  • The exception was paroxetine having markedly lower all-cause discontinuation than doxepin, citalopram and fluoxetine.
  • Difference was noted in the standardised mean differences compared with placebo for efficacy from -6.54 for the best drug (reboxetine) to 0.51 for the worst drug (nefiracetam).
  • ORs compared with placebo for acceptability ranged from 0.09 for the best drug (paroxetine) to 3.42 for the worst drug (citalopram).
  • For the efficacy rank, reboxetine, paroxetine, doxepin and duloxetine served as the most efficacious treatments, the cumulative probabilities of which were 100%, 85.7%, 83.2%, 62.4%, respectively.
  • While taking into account the acceptability rank, paroxetine, placebo, sertraline and nortriptyline were among the most acceptable therapies.
  • Their cumulative probabilities were 92.4%, 63.5%, 57.3%, 56.3%.

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