Saturdays News - Depression

Stroke Recovery and Post-Stroke Depression 

from Wikipedia, the Free Encyclopedia.

Depression is a commonly reported consequence of stroke and is seen in anywhere from 25-50% of patients. The Diagnostic and Statistical Manual (DSM-IV-TR) defines post-stroke depression as “a mood disorder due to a general medical condition (i.e. stroke) that is judged to be due to the direct physiological effects of [that] condition.” Post-stroke depression may involve depressed mood and decreased interest and pleasure that impairs social and occupational functioning, but does not necessarily need to meet the full criteria of a major depressive disorder.

The first studies to look for an association between specific stroke lesions and the occurrence of depression reported a correlation between left frontal lesions and major depression. Damage to the frontal noradrenergic, dopaminergic, and serotonergic projections were thought to cause a depletion of catecholamines that lead to depression. However, more recent studies have demonstrated that the anatomic aspects of a lesion do not necessarily correlate with the occurrence of depression. Other psychological factors can lead to the development of depression including personal and social losses related to the physical disabilities often caused by a stroke.

The incidence of post-stroke depression peaks at 3–6 months and usually resolves within 1–2 years after the stroke, although a minority of patients can go on to develop chronic depression. The diagnosis of post-stroke depression is complicated by other consequences of stroke such as fatigue and psychomotor retardation – which do not necessarily indicate the presence of depression. Loss of interest in activities and relationships should prompt an evaluation for depression.

Chemical structure of the tricyclic antidepressant
amitriptyline. Notice its three rings.

Traditionally, tricyclic antidepressants  (TCAs), such as nortriptyline, have been used in the treatment of post-stroke depression. More recently, the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and citalopram, have become the pharmacologic therapy of choice due to the lower incidence of side effects. Also, psychologic treatment such as cognitive behavioral therapy, group therapy, and family therapy are reported to be useful adjuncts to treatment.

Overall, the development of post-stroke depression can play a significant role in a patient’s recovery from a stroke. For instance, the severity of post-stroke depression has been associated with severity of impairment in activities of daily living (ADLs). By effectively treating depression, patients experience a greater recovery of basic ADLs such as dressing, eating and ambulating, as well as instrumental ADLs, such as the ability to take care of financial and household matters. In essence, recognition and treatment of post-stroke depression leads to greater functional ability for the patient over time.

See the full article Stroke Recovery and Post-Stroke Depression from Wikipedia, the Free Encyclopedia.

Depression in Stroke Survivors

Following a stroke, many people are understandably depressed. Here's help for dealing with this emotional time.

Tackling Depression After Stroke

Escitalopram & Problem Solving Therapy to Prevent Post Stroke Depression

Depression Raises Risk of Stroke Death

From Nottingham - Smoking greatly raises risk of skin cancer, according to a report published in the Archives of Dermatology. Results of a meta-analysis covering 25 studies found that smoking was associated with a 52% increased risk of cutaneous squamous cell carcinoma.

From Boston - Too much salt in the diet may lead to high blood pressure, according to a report published in Circulation. Researchers measured the sodium intake of nearly 6,000 adult men and women over 6 years, finding that those who consumed the most salt were at 21% increased risk of developing high blood pressure.

From London - Depression and anxiety raise risk of dying from stroke, according to a report published in CMAJ. Researchers analyzed data on nearly 70,000 adult men and women over an 8 year period, and found that psychological distress was strongly associated with risk of death from stroke.

Depression May Lead to Stroke

Doctors say they are not sure why but believe that depression may lead to unhealthy habits such as smoking and not eating well.

Depression And Stroke by CBC

Peter Langhorne: Post Stroke - Depression, Anxiety, ...

Topic: Depression, anxiety, emotionalism, fatigue, pain, musculoskeletal pain, shoulder pain, spasticity, central post stroke pain.

Living for Today: the Emotional Reality of Heart Disease and Stroke

After a stroke or heart disease diagnosis, you expect challenges to your physical health. But what about your emotional health? Survivors share how they overcame depression, anger, and other unexpected emotions.

See also: http://heartandstroke.ca/videostories.

Antidepressants Linked to Thicker Arteries

Antidepressant use has been linked to thicker arteries, possibly contributing to the risk of heart disease and stroke.

Background
Antidepressants Linked to Thicker Arteries                                                  (SSTattler: Early studies).

Antidepressant use has been linked to thicker arteries, possibly contributing to the risk of heart disease and stroke, in a study of twin veterans. The data is being presented Tuesday, April 5 at the American College of Cardiology meeting in New Orleans.

Depression can heighten the risk for heart disease, but the effect of antidepressant use revealed by the study is separate and independent from depression itself, says first author Amit Shah, MD, a cardiology fellow at Emory University School of Medicine. The data suggest that antidepressants may combine with depression for a negative effect on blood vessels, he says. Shah is a researcher working with Viola Vaccarino, MD, PhD, chair of the Department of Epidemiology at Emory's Rollins School of Public Health.

The study included 513 middle-aged male twins who both served in the U.S. military during the Vietnam War. Twins are genetically the same but may be different when it comes to other risk factors such as diet, smoking and exercise, so studying them is a good way to distill out the effects of genetics, Shah says.