Deans' stroke musings: Comparative Efficacy of Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the Management of Post-stroke Depression: A Systematic Review of Randomized Controlled Trials

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.

Sunday, May 25, 2025

Comparative Efficacy of Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the Management of Post-stroke Depression: A Systematic Review of Randomized Controlled Trials

You wouldn't need depression meds if you had 100% recovery protocols! Or are you that blitheringly stupid you can't see solving the primary problem negates the need for working on the secondary problem? Well, ARE YOU STUPID OR NOT? Your patients would like to know your intelligence level.

Comparative Efficacy of Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the Management of Post-stroke Depression: A Systematic Review of Randomized Controlled Trials

Zarin Nudar Rodoshi • Sharen Shibu • Osman Omer • Hamza Tallal • Muhammad Zubair Dawud Gondal • Zayam Shahid • Ayesha Azam • Noor Abbas

Published: May 25, 2025 DOI: 10.7759/cureus.84784

Peer-Reviewed Cite this article as: Rodoshi Z, Shibu S, Omer O, et al. (May 25, 2025) Comparative Efficacy of Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the Management of Post-stroke Depression: A Systematic Review of Randomized Controlled Trials. Cureus 17(5): e84784. doi:10.7759/cureus.84784

Abstract

Post-stroke depression (PSD) is a common neuropsychiatric complication that adversely affects rehabilitation outcomes, cognitive recovery, and quality of life in stroke survivors. While selective serotonin reuptake inhibitors (SSRIs) are widely used as first-line treatment, serotonin-norepinephrine reuptake inhibitors (SNRIs) have emerged as potential alternatives with broader neurochemical targets. This systematic review aimed to compare the efficacy of SSRIs and SNRIs in the treatment and prevention of PSD. A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Google Scholar in accordance with PRISMA guidelines, applying filters for English-language clinical trials. Five randomized controlled trials met the inclusion criteria and were analyzed. The findings revealed that both SSRIs and SNRIs significantly improved depressive symptoms, with escitalopram showing early and superior antidepressant effects compared to sertraline. SNRIs like duloxetine and reboxetine demonstrated added benefits in cognitive outcomes, prevention of PSD, and symptom subtype-specific efficacy, particularly in retarded depression. While the overall risk of bias was low in most studies, limitations such as small sample sizes and limited direct head-to-head comparisons were noted. These results support the clinical utility of both drug classes and emphasize the need for individualized pharmacologic strategies based on patient characteristics and symptom profiles.