Assessment of clinical manifestations and treatment of post-stroke depression in young patients with ischemic stroke

Abstract

To consider clinical manifestations and treatment of post-stroke depression in young patients with carotid ischemic stroke. Forty patients, 24 women and 16 men, aged from 18 to 45 years old, diagnosed with ICD-10 post-stroke depression were examined. All patients underwent neurological examination, brain MRI and MR-angiography of cerebral vessels. The following psychometric tests were used: MMSE, Hamilton depression scale, CES-D depression scale, a questionnaire on nocturnal sleep assessment, and Epworth Sleepiness Scale. The Recovery Locus of Control Questionnaire was administered to evaluate motivation level for the post-stroke recovery. Patients were divided into two groups: group 1 (n=22) received basic treatment including milnacipran hydrochloride (ixel) in dose 1 capsule twice a day during 3 months, group 2 received only basic treatment. Psychometric testing was performed 2 month after stroke before the treatment and 3 month after the end of treatment. Patients demonstrated positive (melancholy, anxiety, intellectual and motor inhibition) and negative affectation (apathy, dysphoria) accompanied by somatic/autonomic disorders, in particular, sleep deficiency. A marked therapeutic effect of ixel was shown in group 1. The number of patients with depression decreased significantly after treatment compared to group 2. Sleep improvement and increased motivation levels for recovery were observed as well.