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Clinical Drug Investigation
Published in: Clinical Drug Investigation 10/2017

01-10-2017 | Systematic Review

Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: See-Hwee Yeo, Zheng-Jie Ian Lim, Jia Mao, Wai-Ping Yau

Published in: Clinical Drug Investigation | Issue 10/2017

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Abstract

Background and Objective

Pilot trials have suggested that pharmacotherapy may aid stroke recovery. The aim of this study was to systematically review the effects of antidepressants, anti-Alzheimer drugs, anti-Parkinson drugs, central nervous system (CNS) stimulants and piracetam on gross motor function, cognition, disability, dependency and quality of life (QOL) after stroke.

Methods

PubMed, EMBASE and the Cochrane Central Register of Controlled Trials databases were searched, and 44 randomized controlled trials that compared outcomes of interest between drug treatment and placebo or no treatment were included. For each study, standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) were calculated. Meta-analyses were conducted to pool results using either the fixed-effects or random-effects model.

Results

Selective serotonin reuptake inhibitors (SSRIs) improved gross motor function (SMD 0.54, 95% CI 0.22–0.85; three studies), disability (SMD 0.49, 95% CI 0.32–0.66; 14 studies) and QOL (MD 6.46, 95% CI 4.71–8.22; two studies), but there was insufficient evidence for their use in enhancing global cognition (SMD 0.23, 95% CI −0.01 to 0.46; five studies) and dependency (risk ratio 0.81, 95% CI 0.68–0.97; one fluoxetine study). In particular, gross motor function was improved by fluoxetine (SMD 0.64, 95% CI 0.31–0.98; two studies), while disability was improved by paroxetine (SMD 1.05, 95% CI 0.63–1.46; two studies), citalopram (SMD 0.51, 95% CI 0.08–0.93; two studies) and fluoxetine (SMD 0.41, 95% CI 0.22–0.60; nine studies). There is insufficient evidence for the use of anti-Alzheimer drugs, anti-Parkinson drugs, CNS stimulants and piracetam to promote stroke recovery.

Conclusions

Administration of SSRIs may improve gross motor function, reduce disability and enhance QOL for patients recovering from stroke.
Appendix
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Metadata
Title
Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors
See-Hwee Yeo
Zheng-Jie Ian Lim
Jia Mao
Wai-Ping Yau
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation / Issue 10/2017
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-017-0558-4

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