Post-stroke depression (PSD) is a type of emotional disorder caused by a stroke, with the features of both depression as well as hypofunction. PSD is a frequently encountered neurological complication in older patients who have had strokes, with senile post-stroke depression (SPSD) being prevalent in 20–79% of cases. It affects the neurorehabilitation of patients and increases the risk of stroke-related mortality.

A recent study investigated the efficacy and safety of agomelatine, sertraline, and escitalopram for patients with senile post-stroke depression, aged over 65 years.

The study enrolled 165 patients with post-stroke depression (PSD) who were randomized into four groups and given an anti-depressant or a placebo as follows: group A (agomelatine along with conventional cerebrovascular disease medication); group B (sertraline along with conventional cerebrovascular disease medication); group C (escitalopram along with conventional cerebrovascular disease medication) and, a control group (conventional treatment alone). 

The efficacy of the treatments was evaluated employing the Hamilton Depression Scale (HAMD), the National Institute of Health Stroke Scale (NIHSS), and the Activities of Daily Living (ADL) Barthel index (BI) at one, two, four, and six weeks after treatment initiation.

The patients who received one of the three antidepressant treatments showed significant improvement in the HAMD, NIHSS score, and BI index than the control group. However, no significant difference was observed between the three groups that received anti-depressant medication. The general adverse effects of the treatments were reported to be mild in all three groups, and patients generally tolerated the treatments.

Thus, improvement in the HAMD, NIHSS score, and BI index indicates that the conditions of Patients with SPSD can be improved by administering any of the three drugs, i.e. agomelatine, sertraline, or escitalopram.

Clinical Neurology and Neurosurgery. 2021;205. https://doi.org/10.1016/j.clineuro.2021.106651.