Minocycline, a derivative of tetracycline, appears to reduce disability from acute ischemic stroke, even given up to 24 hours after the onset of signs and symptoms. Most other treatments must be given 3 to 6 hours after symptom onset to offer any benefit.

In a study, 74 patients who received 200 mg of minocycline orally for 5 days were compared with 77 patients who received a placebo. Therapy was initiated between 6 and 24 hours after stroke onset. Researchers used standard stroke scoring systems to assess patients' functional disability for 90 days.

Patients treated with minocycline had significantly reduced disability compared with patients who received a placebo. Minocycline's benefits were evident within 1 week of the stroke. No differences in deaths, myocardial infarction, recurrent stroke, or hemorrhagic transformation were found between the two groups. The results are consistent with earlier animal research showing that minocycline has a neuroprotective effect.

The researchers call for more study to determine the optimal dose and to examine the effectiveness of intravenous minocycline.

Source: Lampl Y, et al., Minocycline treatment in acute stroke: An open-label, evaluator-blinded study, Neurology, October 2, 2007.