Selective Serotonin Reuptake Inhibitors

Abstract

Selective serotonergic reuptake inhibitors (SSRIs) are a class of medications used frequently to address issues related to stroke and post-stroke recovery. Health care providers who care for stroke patients will need to familiarize themselves with their applications in stroke treatment. These medications are primarily used to treat depression but have been used in other conditions including pain management. Recent evidence from the FLAME trial suggests that SSRIs may facilitate motor recovery after a stroke through neuroplastic mechanisms. This chapter reviews the uses and indications in stroke survivors and examines the evidence to support those indications. The chapter begins with a general review of the SSRI class of medication focusing on the pharmacology and indications in non-stroke-related conditions. We then highlight the data for post-stroke functional recovery along with indications for post-stroke depression, motor recovery, pain syndromes, and neuroplasticity. A key finding is that SSRIs seem to have additional effects even when depression is accounted for in the studies.