Currently, escitalopram remains the most commonly used SSRI, which has the characteristics of quick onset, fewer interactions with other drugs, and relative safety. 

The present study investigated the effects of escitalopram on neural functional prognoses and endothelial dysfunction after acute ischemic stroke (AIS). It enrolled One hundred patients afflicted with acute ischemic stroke and randomized them into control and treatment groups. Patients in the treatment group received escitalopram along with the basic therapies in the control group over 90 days. 

The study quantified Neurological deficits using the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) score; determined cognitive impairment using the Mini-Mental State Examination (MMSE) score, measured depressive symptoms using the 17-item Hamilton Depression Rating Scale (HAMD). Furthermore, the study defined post-stroke depression (PSD) based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), with a HAMD score ≥17. 

The study found-

• Significantly lower mean NIHSS and HAMD scores on day 90 after treatment in the treatment group than in the control group 
• Significantly higher mean BI score and FMD in the treatment group than in the control group. 
• A similar improvement in MMSE score in both groups. 

This study suggests that early treatment with escitalopram after ischemic stroke improves functional neural prognoses and endothelial dysfunction. Escitalopram possesses fewer side effects, which is worthy of clinical prophylactic application.

Cao J-X, Liu L, Sun Y-T, et al., escitalopram improves neural functional prognosis and endothelial dysfunction in patients with acute cerebral infarction. Restorative Neurology and Neuroscience. 2020;38(5):385-393.