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Review
. 2022 Dec 26;14(12):e32948.
doi: 10.7759/cureus.32948. eCollection 2022 Dec.

Poststroke Depression, An Underrated Clinical Dilemma: 2022

Aneeque Jamil  1 , Denise Csendes  1 , Sai Dheeraj Gutlapalli  1 , Keerthana Prakash  1 , Kiran Maee Swarnakari  1 , Meena Bai  2 , Mohana Priya Manoharan  1 , Rabab Raja  2 , Aditya Desai  3   4 , Darshi M Desai  1 , Ana P Arcia Franchini  5
Affiliations
Review

Poststroke Depression, An Underrated Clinical Dilemma: 2022

Aneeque Jamil et al. Cureus. .

Abstract

It is known that the majority of patients are prone to develop depression following a stroke. Several biological factors, including the disruption of the hypothalamic and adrenal axis and changes in cortisol and interleukin 6 (IL6), are said to have an essential role in its development. Magnetic resonance imaging (MRI) scans point toward white matter lesions and lacunar infarcts as the primary pathological culprit. People affected by poststroke depression (PSD) are more likely to commit suicide or develop another ischemic event after the initial episode, which can likely increase the mortality related to PSD and stroke. Selective serotonin reuptake inhibitors (SSRIs) are the mainstay of treatment for PSD. However, it has a poor safety profile and is not very productive, making the use of SSRIs controversial, and further studies are required to prove its benefits concerning PSD. This literature review discusses the importance of PSD, how it impacts the quality of life of people affected by stroke, and its treatment.

Keywords: depression; poststroke depression; stroke; stroke and mental health; stroke and psychiatry.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Proposed pathophysiology of PSD (upward arrow: increased).
Figure credits: Aneeque Jamil PSD, poststroke depression
Figure 2
Figure 2. Neuropathological study in PSD.
Figure credits: Aneeque Jamil n, number of patients; PSP, progressive supranuclear palsy; PSD, poststroke depression
See this image and copyright information in PMC

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