SSRIs in Stroke Patients: A New Lexapro Study

Journal of the American Medical Association reports on a study suggesting that doctors may want to prescribe stroke victims antidepressants right away. Researchers in Iowa gave low doses of the SSRI antidepressant Lexapro to stroke patients. The patients on the drug were 4.5 times less likely to develop depression than patients given a placebo.

If this study is replicated, the results are astonishing given the rather limited efficacy of SSRIs generally. Similar findings may lead to the use of the much maligned SSRI antidepressants despite the criticism of recent years. Almost a quarter of a million Americans develop depression within two years after having a stroke. As is often the case, depression impacts outcome: stroke patients with depression recover less quickly and are more likely to die.
SSRIs, such as Prozac, Lexapro, Cipralex, Esertia, and Zoloft, have a lot of troubling side effects. While it took almost a decade for the labeling to reflect the risks, SSRIs cause an increased risk of suicidal thoughts and actions. The New England Journal of Medicine and other medical journals have also reported that some SSRI antidepressants are linked to an increased risk of persistent pulmonary hypertension (PPHN) in children whose mothers used SSRIs after the 20th week of gestation. SSRIs have also been linked to heart, cranial, lung and abdominal defects. If all of that is not enough, extreme reactions have also been reported in patients when they stop taking some SSRIs.

Does this mean that SSRIs should not be on the market? If this Lexapro study is any indication, the answer is that there are some cases where the side effects of these SSRIs may be worth the risk. The problem is that SSRIs have been billed to general practitioners as a cure all panacea with no side effects for anyone with symptoms of depression. But, unfortunately, there is no such drug and the prescription of antidepressants should be done with more care and consideration to the risks as well as the benefits of these drugs.