Prozac counters emotional turmoil after stroke

The antidepressant Prozac (fluoxetine) may help relieve certain emotional disturbances in patients who've suffered a stroke, Korean researchers report. As senior investigator Dr. Jong S. Kim told Reuters Health, Prozac significantly improved "emotional incontinence and anger proneness, but not depression."

There have been few controlled studies of so-called selective serotonin reuptake inhibitors (SSRIs) like Prozac in patients with stroke-related emotional disturbance. Most attention has been given to post-stroke depression, but recent studies have suggested that post-stroke emotional incontinence or anger proneness is also common.

Kim, of Asan Medical Center, Seoul, and colleagues, randomly assigned 152 stroke patients who met criteria for post-stroke depression, emotional incontinence or proneness to anger to Prozac (20 mg daily) or to placebo for 3 months.

Patients taking Prozac showed significant improvement in measures of emotional incontinence and proneness to anger. Reduction in propensity for anger continued to be seen even 3 months after discontinuation of the drug. However, there was no definitive improvement in poststroke depression.

Prozac was generally well tolerated - 71 percent of Prozac-treated patients had no side effects, as was the case for 83 percent of placebo-treated patients. Ten patients in the active treatment group and two placebo patients dropped out because of side effects.

Post-stroke emotional problems are "prevalent and potentially treatable," Kim said, yet are often overlooked, and may harm quality of life of stroke patients and their caregivers.

Future studies, the researchers say, are needed to see if Prozac can improve the quality of life of stroke patients, and decrease caregiver burden.

SOURCE: Stroke January 2006.