Deans' stroke musings: The association of neurostimulant and antidepressant use with functional recovery during stroke rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, July 19, 2018

The association of neurostimulant and antidepressant use with functional recovery during stroke rehabilitation

But does this contradict this earlier research? Inquiring minds demand to know.
Don't listen to me, I'm not medically trained.

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

https://www.sciencedirect.com/science/article/pii/S1877065718305189

https://doi.org/10.1016/j.rehab.2018.05.444 Get rights and content

Introduction/Background

Different therapies may be required to support recovery after stroke. Although the primary method is intensive rehabilitation therapy, medications may augment therapist-led rehabilitation. The purpose of this study was to describe the differences in admission motor and cognitive function for stroke patients who received neurostimulants or antidepressants during acute rehabilitation compared with patients without each of these medications, and determine the association between medication use and functional recovery.

Material and method

We examined data for a patient cohort who received acute rehabilitation at three facilities in the United States from 2009–2014. From the electronic medical record we obtained sociodemographics, clinical characteristics, and whether neurostimulants or antidepressants were prescribed and administered within one week of rehabilitation admission. Functional status as the outcome was measured by the Functional Independence Measure (FIM - higher score is better function). After excluding patients using both medications, we modeled use of each medication for its association with FIM motor, cognitive and total scores at discharge from inpatient rehabilitation.

Results

Patients in this cohort were 66 years of age (median), 49% were female, and the acute rehabilitation length of stay was 16 days (median). Neurostimulants or antidepressants were not prescribed for 2159 patients whereas 526 (19.6%) received a neurostimulant and 700 (24.5%) an antidepressant. Motor and cognitive functions were significantly more impaired on admission for patients who received the neurostimulant or the antidepressant (Fig. 1). After adjusting for sociodemographics and clinical characteristics, receipt of neurostimulants or antidepressants was not associated with discharge FIM motor and was associated with a lower discharge FIM-cognitive score (P lt; 0.01).

Conclusion

In this stroke rehabilitation patient cohort, medication therapy with neurostimulants and antidepressants was associated with more impaired cognitive function at discharge but no longer a difference in motor function. Further research is needed to determine how medications interact to assist in functional recovery.