One of the most common effects of stroke is mood disorder, typically manifesting as depression. Depression can develop immediately following a stroke or many months later. Antidepressant medications, including Prozac (fluoxetine), are considered standard treatment for post-stroke depression. However, administration of drugs to individuals who may already be highly medicated presents some potential complications, and drug interactions and side effects may lead to reduced effectiveness. A solution to the problem of post-stroke depression that relies less on pharmaceutical treatments would be ideal, and research on that topic is moving forward.
A study underway in Hong Kong will determine if a form of acupuncture may add to the overall effectiveness of Prozac. People who have recently experienced a stroke and have been diagnosed with major depression will be eligible for the study. Researchers will consider a score on the Hamilton Depression Scale (a standard rating system for depression) of 16 or greater as sufficient for the purposes of the experiment. Those with severe cognitive dysfunction or any other chronic disorder, such as alcoholism or heart disease, will not be eligible. In addition, people with difficulty using language because of stroke, a condition called aphasia, are ineligible.
The study will include a placebo group and an experimental group. The experimental group will receive electroacupuncture on the scalp and body and a six-week course of Prozac. For the control group, electrical stimulation will be used rather than acupuncture. Researchers assessing improvement in depression symptoms will not know to which group each individual belongs. Ultimately, study authors hope to include 60 adults between the ages of 35 and 80 for this experiment. The primary outcome is significant improvement in depression scores throughout the trial. As a secondary outcome, researchers hope that the combination of electroacupuncture with Prozac will lead to fewer adverse events and better treatment response overall.
Alternative interventions, such as electroacupuncture and massage, have recently gained credibility in the Western medical establishment. In the case of post-stroke depression, finding treatments that can reduce the pharmaceutical burden on patients is important. A stroke can do enormous damage to a person’s neural network of synapses and nerve fibers. Post-stroke depression almost certainly has a physical cause, but treatment is still less than adequate. The Hong Kong study may begin to change the prognosis for stroke survivors, lessening the chances of long-term complications and mood disturbances.
Electroacupuncture Combined With Antidepressants for Post-stroke Depression. (n.d.). ClinicalTrials.gov. Retrieved July 5, 2012, from http://clinicaltrials.gov/ct2/show/NCT01174394?recr=Open&intr=%22Fluoxetine%22&rank=12
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