CNS Drugs:SSRIs在改善脑卒中后功能结局上有何作用?

2018-10-27 吴星 环球医学网

2018年10月,发表于《CNS Drugs》上的一项研究,考察了选择性5-羟色胺再摄取抑制剂(SSRIs)改善脑卒中后功能结局方面的潜在作用。

2018年10月,发表于《CNS Drugs》上的一项研究,考察了选择性5-羟色胺再摄取抑制剂(SSRIs)改善脑卒中后功能结局方面的潜在作用。

过去几十年来,急性卒中治疗取得的巨大进展极大地改变了卒中后的生活。然而,静脉溶栓治疗和血管血栓切除术受到相对狭窄的时间窗或治疗禁忌证的限制。此外,纵然身体问题或许几乎消失,使用急性再灌注疗法的患者由于潜在脑梗死还存在认知和情感方面的并发症。

总之,卒中仍然是全世界成人失能和死亡的一个常见原因。需要提供更多最好在急性期后也可行的治疗方案,以改善康复。尽管多种药物和治疗方式促进卒中后康复的潜力得以研究,但是,没有明确可以增强康复进程的治疗。一类有希望的治疗药物是SSRIs,这是一类常用的具有神经再生特性的抗抑郁药物。

这篇研究回顾了SSRIs作为卒中恢复潜在增强剂的证据,并讨论了所报告影响的潜在机制以及对卒中后患者管理的影响,包括潜在的不良事件和药物-药物相互作用。

原始出处:
Mortensen JK1, Andersen G2.Potential Role of Selective Serotonin Reuptake Inhibitors in Improving Functional Outcome after Stroke.CNS Drugs. 2018 Oct;32(10):895-903. doi: 10.1007/s40263-018-0573-x.

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    2019-09-01 lg.zhao
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    2019-02-22 wangbingxhy
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    2018-10-30 tsing_hit
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    2018-10-27 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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卒中和抑郁的共病并非少见。5-羟色胺再摄取抑制剂(SSRIs)是临床上最常用的一线抗抑郁药之一。有研究显示,SSRIs会增高颅内出血的风险,亦有研究发现其对缺血性卒中具有神经保护作用。关于发病前应用SSRIs对卒中预后的影响,目前较少报道。 近期,丹麦奥胡斯大学的Mortensen教授等对全国(丹麦)2003年-2012年间登记在案的患者资料进行了一项回顾性队列研究,

Stroke:选择性5-羟色胺再摄取抑制剂对脑卒中患者溶栓治疗后脑出血和预后的影响!

由此可见,在这个队列研究中,入院前服用SSRIs与溶栓后sICH风险增加并不显著相关。然而,亚组分析表明,在同时服用SSRI和OAC患者中sICH的风险显著增加。入院前服用SSRIs治疗与预后不良有关,这可能反映了卒中前抑郁症的预后价值。