Gamma Aminobutyric Acid Receptor Agonists for Acute Stroke

Now if we just had some doctors with initiative, we could be trying out this along with my earlier 177 hyperacute options and actually save trillions of neurons from dying. Or just a very loud mouth type A personality that won't take doing nothing for an answer. I bet it will be the type A personality that advances stroke rehab rather than any doctor, but I'm willing to be proven wrong.
http://stroke.ahajournals.org/content/44/6/e65

Introduction

Gamma aminobutyric acid (GABA) receptor agonists have shown to be effective in reducing infarct size and improving functional outcome in animal models of cerebral ischemia. However, the sedation effects of GABA receptor agonists limited the application in acute stroke patients because of the potential risk of stupor.

Materials and Methods

Objective

The aim of this study is to determine the efficacy and safety of GABA receptor agonists in the treatment of acute stroke.

Types of Studies

Randomized controlled trials.

Types of Participants

Acute stroke patients within 12 hours after stroke onset.

Types of Interventions

GABA receptor agonists in comparison with placebo.

Primary Outcomes

Death or dependency, defined as a Barthel Index score of ≤60, or the modified Rankin Scale graded 3 to 5, and adverse events.

Secondary Outcomes

Functional independence, defined as Barthel Index score >60, or modified Rankin Scale <3, and neurological function measured by other stroke scales.

Results

We included 5 trials with 3838 randomized patients. The methodological quality of the included trials was generally good, with low risk of bias. Four trials measured death and dependency at 3 months in chlormethiazole versus placebo without significant difference (2909 patients; risk ratio [RR], 1.03, 95% confidence interval [CI], 0.95–1.11). One trial measured this outcome between diazepam and placebo (849 patients; RR, 0.94; 95% CI, 0.82–1.07). In the subgroup analysis of total anterior circulation syndrome, a higher percentage of functional independence was found in the chlormethiazole group (635 patients; RR, 1.33; 95% CI, 1.09–1.64). The frequent adverse events related to chlormethiazole were somnolence (2527 patients; RR, 4.56, 95% CI, 3.50–5.95) and rhinitis (2527 patients; RR, 4.75, 95% CI