While acute thrombolytic therapy has advanced stroke care, it must be administered within a few hours of a stroke to provide benefit. Researchers have been investigating various restorative treatments in an attempt to find a therapy that can be beneficial several months after a stroke. In this study, Jorge and colleagues evaluated the use of escitalopram, a selective serotonin reuptake inhibitor (SSRI), in stroke patients. A total of 129 patients were randomized (117 began treatment) within three months of an ischemic or hemorrhagic stroke to receive escitalopram (10 mg per day in patients younger than 65 and 5 mg per day in patients 65 or older), placebo, or Problem Solving Therapy (PST) for one year. Results of baseline neuropsychological testing for memory and executive functioning were similar in all three groups.

Study results showed that patients receiving escitalopram had greater improvement in tests measuring global cognitive functioning than those receiving placebo or PST. In particular, verbal and visual memory scores were higher in the escitalopram group than in the other groups. Improvement in the escitalopram group was unrelated to stroke type or to the mechanism of ischemic stroke, and the drug was well tolerated.

Although these results demonstrate that an SSRI can improve memory and executive functioning in patients who've experienced a stroke, the authors note that this study was conducted in a specific population: patients with mild-to-moderate stroke in a specialized unit who were not depressed. Therefore, the results cannot be generalized to other populations. Nevertheless, the authors suggest that the use of antidepressants in stroke patients should be further evaluated.