The Efficacy of Citalopram for Poststroke Depression and Its Effect on Stroke Rehabilitation

Objectives： To observe the efficacy of citalopram in the treatment of poststroke depression （PSD） and its effect on stroke rehabilitation. Methods： A total of the 105 patients with PSD were randomly allocated into citalopram-treated group （n = 52） and control group （n = 53）. Both groups were treated with conventional drugs, and citalopram was added to the treated group. The depression status of the patients was evaluated by using Hamilton Rating Scale for Depression （HRSD） before and after the treatment, their cognitive and neurological status was evaluated by using Mini-Mental State Examination （MMSE）, Chinese Stroke Scale （CSS） and Barthel Index （BI） 4 and 12 weeks before and after the treatment. Results： One patient died and another was lost to follow-up in the citalopram-treated group. Two patients died and two were lost to follow-up in the control group. Twelve weeks after the treatment, the cure rate and overall effective rate in the citalopram-treated group were 64% and 96%, respectively; they were significantly higher than the control group （16.33% and 57.44% ; P 〈 0.05）. The MMSE score increased more significantly in the citalopram-treated group than that in the control group 4 and 12 weeks after the treatment （P 〈 0.01 ）. Both CSS and BI improved in the 2 groups 4 weeks after the treatment, but there was no significant difference. CSS and BI scores in the citalopram-treated group were better than those in the control group 12 weeks after the treatment （P 〈 0.01 ）. The major side effects of citalopram were digestive and central nervous system symptomes; however, these were mild and transient. Conclusions： Citalopram is safe and effective in the treatment of PSD, and it may improve cognitive function, neurological function, and outcome at 12 weeks. Key words: citalopram;  depression;  stroke;  rehabilitation