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Review
. 2025 May 18:2025:6893801.
doi: 10.1155/srat/6893801. eCollection 2025.

Pharmacotherapy for Poststroke Cognitive Impairment and Poststroke Cognitive Impairment With Dementia: A Review

Renju Ravi  1 , Saibal Das  2   3 , Tahir Hakami  1 , Prakash B M  1 , Libby Pushparajan  4
Affiliations
Review

Pharmacotherapy for Poststroke Cognitive Impairment and Poststroke Cognitive Impairment With Dementia: A Review

Renju Ravi et al. Stroke Res Treat. .

Abstract

Poststroke cognitive impairment (PSCI) refers to any level of cognitive decline occurring after a stroke, ranging from mild to severe impairments, while PSCI with dementia describes a more severe form where the cognitive decline significantly affects daily functioning and meets the clinical criteria for dementia. PSCI occurs in more than half of individuals who have had a stroke. Despite its high prevalence, the pharmacotherapeutic options for PSCI are limited. Several pharmacotherapeutic options like cholinesterase inhibitors (e.g., donepezil, galantamine, and rivastigmine) and N-methyl-d-aspartate receptor antagonists (e.g., memantine) have shown potential in improving cognitive functions. However, their overall effectiveness remains inconsistent across different studies and patient populations. Newer drugs such as citicoline, cilostazol, and antidepressants have shown promise, but further research is needed to validate their efficacy and safety specifically for PSCI management.

Keywords: cholinesterase inhibitors; cognitive impairment; pharmacotherapy; poststroke; vascular dementia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Major risk factors for poststroke cognitive impairment.
Figure 2
Figure 2
Heatmap representing the effectiveness of various drugs used for poststroke cognitive impairment.
See this image and copyright information in PMC

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