EXPLORE!

CNS Update: PSD Symptoms: Varying Responses to Escitalopram by Individual Symptoms and Lesion Location

  1273 Views

eMediNexus    29 December 2022

Antidepressants may deliver different efficacies in post-stroke depressive symptoms (PSD). So a study investigated the effectiveness of escitalopram on PSD, based on distinct depressive symptoms and stroke lesion location.

Depressive manifestations were assessed by employing the Montgomery-Åsberg Depression Rating Scale (MADRS). Shifts in MADRS and individual item scores after 12 weeks were compared between the treatment and the stroke lesion location groups. 

Stroke lesion locations were clustered based on the anatomical distribution of serotonin fibers originating from the midbrain/pons and spreading to the forebrain via subcortical structures: “Midbrain-Pons,” “Frontal-Subcortical,” and “Others.” 

Total MADRS scores were seen to be markedly reduced in the escitalopram than in the placebo group.

However, escitalopram displayed a substantial effect in exclusively 3 items: apparent sadness, reported sadness, and pessimistic thoughts. 

The lesion location analyses showed escitalopram users in the Frontal-Subcortical group to have significant improvement in total MADRS scores, but not in the Midbrain-Pons and Others groups.

 

These outcomes suggest a more pronounced effect of escitalopram on PSD in patients with certain depressive symptoms and stroke lesion locations. Thus the treatment strategies must be tailored accordingly.

 

Source: Journal of Geriatric Psychiatry and Neurology. 2021;34(6):565-573. doi:10.1177/0891988720957108

To comment on this article,
create a free account.

Sign Up to instantly get access to 10000+ Articles & 1000+ Cases

Already registered?

Login Now

Most Popular Articles

News and Updates

eMediNexus provides latest updates on medical news, medical case studies from India. In-depth medical case studies and research designed for doctors and healthcare professionals.