http://www.ncbi.nlm.nih.gov/pubmed/23438654
Abstract
Pharmacological
enhancement of neurorehabilitation is based on the concept of
neuroplasticity. Agents with probably unfavourable effects on recovery
(e.g. classical antiepileptic drugs, butyrophenones) should be avoided.
The findings of experimental studies in animal models, investigations in
healthy subjects and the findings of neurophysiological studies
indicate that there is scope for benefit from pharmacological
enhancement in stroke rehabilitation in the clinical setting - in
addition to rehabilitative therapies. Randomized controlled clinical
trials have shown benefit of pharmacological enhancement in stroke
rehabilitation for some agents. Nevertheless, the clinical evidence
regarding benefits of this treatment approach is still considered weak
for the following reason: First, the beneficial findings of some studies
were not confirmed by others. Second, several studies were limited by
small patient populations and narrow inclusion criteria. Third, there
were concerns regarding safety of some agents (i.e., piracetam, and
amphetamines). Dopaminergic agents, Selective
Serotonin-Reuptake-Inhibitors (SSRI) and acetylcholinesterase-inhibitors
are promising candidates. Their safety and efficacy should be further
investigated; ideally in - sufficiently powered - large randomized
controlled trials.
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