Effects of serotonin reuptake inhibitors in neuronal plasticity after stroke

Authors

  • Gustavo José Luvizutto Fisioterapeuta, Núcleo de Reabilitação, Faculdade de Medicina de Botucatu (UNESP), Botucatu-SP, Brasil.
  • Rodrigo Bazan Professor de Neurologia do Departamento de Neurologia, Psicologia e Psiquiatria da Faculdade de Medicina de Botucatu, Botucatu-SP, Brasil.
  • Gabriel Pereira Braga Médico Neurologista da Unidade de AVC da Faculdade de Medicina de Botucatu (UNESP), Botucatu-SP, Brasil.
  • Gustavo Wruck Kuster Médico Neurologista da Escola de Medicina do ABC, Santo André-SP, Brasil.
  • Marcos Cristiano Lange Médico do Departamento de Neurologia do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba-PR, Brasil.
  • Viviane Flumignan Zetola Professora de Neurologia do Departamento de Neurologia do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba-PR, Brasil.

DOI:

https://doi.org/10.34024/rnc.2015.v23.8035

Keywords:

Stroke, Serotonin Reuptake Inhibitors, Drug Therapy, Neuronal Plasticity, Motor Activity, Rehabilitation

Abstract

Introduction. Recently, selective serotonin reuptake inhibitors (SS­RIs) have been highlighted as neuroplasticity agents for improving functional and motor recuperation in patients after stroke. Objective. Considering the availability of these drugs in our context, even in the public healthcare system, we aimed to undertake a review of the litera­ture in order to improve the decision-making process. Method. The review, based on data up to February 2013,included studies that took into account neuroprotective and anti-fatigue properties, and effect on motor recuperation capacity after stroke. Results. The control and randomized studies (RCT) found: motor recuperation improvement with the use of Fluoxetine, evaluated by the Fugl-Meyer Motor Scale after 90 days of treatment; improvement of functional independence, by modified Rankin scale and Barthel’s index, with the use of Nor­triptyline; greater activation in the contralateral sensory-motor cortex after the use of paroxetine and no positive effect on the control of fatigue after stroke. Conclusion. The studies suggest better functional and motor recuperation with SSRI use. It was not possible to deter­mine a difference among the agents, since the available studies are not comparative and were tested with different drugs; these and other gaps are being addressed by ongoing studies.

References

Cincura C, Pontes-Neto OM, Neville IS, Mendes HF, Menezes DF, Mariano DC, et al. Stroke Scale, Modified Rankin Scale and Barthel Index in Brazil: The Role of Cultural Adaptation and Structured Interviewing. Cerebrovasc Dis 2009; 27:119-22. http://dx.doi.org/10.1159/000177918 DOI: https://doi.org/10.1159/000177918

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart Disease and Stroke Statistics--2013 Update: A Report From the American Heart Association. Circulation 2013;127:6-245. http://dx.doi.org/10.1161/CIR.0b013e31828124ad DOI: https://doi.org/10.1161/CIR.0b013e31828124ad

Saposnik G, Mamdani M, Bayley M, Thorpe KE, Hall J, Cohen LG, et al. Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST): rationale, design, and protocol of a pilot randomized clinical trial assessing

the Wii gaming system. Int J Stroke 2010;5:47-51. http://dx.doi.org/10.1111/j.1747-4949.2009.00404.x DOI: https://doi.org/10.1111/j.1747-4949.2009.00404.x

Chollet F, Tardy J, Albucher JF, Thalamas C, Berard E, Lamy C, et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol 2011;10:123-30. http://dx.doi.org/10.1016/S1474-4422(10)70314-8 DOI: https://doi.org/10.1016/S1474-4422(10)70314-8

Pariente J, Loubinoux I, Carel C, Albucher JF, Leger A, Manelfe C, et al. Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke. Ann Neurol 2001;50:718-29. DOI: https://doi.org/10.1002/ana.1257

Loubinoux I, Pariente J, Boulanouar K, Carel C, Manelfe C, Rascol O, et al. A single dose of the serotonin neurotransmission agonist paroxetine enhances motor output: double-blind, placebo-controlled, fMRI study in healthy subjects Neuroimage 2002;15:26-36. http://dx.doi.org/10.1006/nimg.2001.0957 DOI: https://doi.org/10.1006/nimg.2001.0957

Berends HI, Nijlant J, van Putten M, Movig KL, IJzerman MJ. Single dose of fluoxetine increases muscle activation in chronic stroke patients. Clin Neuropharmacol 2009;32:1-5. http://dx.doi.org/10.1097/WNF.0b013e3181633482 DOI: https://doi.org/10.1097/WNF.0b013e3181633482

Dam M, Tonin P, De Boni A, Pizzolato G, Casson S, Ermani M, et al. Effects of fluoxetine and maprotiline on functional recovery in poststroke hemiplegic patients undergoing rehabilitation therapy. Stroke 1996;27:1211-4. http://dx.doi.org/10.1161/01.STR.27.7.1211 DOI: https://doi.org/10.1161/01.STR.27.7.1211

Mikami K, Jorge RE, Adams HP, Davis PH, Leira EC, Jang M, et al. Effect of antidepressants on the course of disability following stroke. Am J Geriatr Psychiatry 2011;19:1007-15. http://dx.doi.org/10.1097/JGP.0b013e31821181b0 DOI: https://doi.org/10.1097/JGP.0b013e31821181b0

Choi-Kwon S, Choi J, Kwon SU, Kang DW, Kim JS. Fluoxetine is not effective in the treatment of post-stroke fatigue: a double-blind, placebo-controlled study. Cerebrovasc Dis 2007;23:103-8. http://dx.doi.org/10.1159/000097045 DOI: https://doi.org/10.1159/000097045

Barker-Collo S, Feigin VL, Dudley M. Post stroke fatigue--where is the evidence to guide practice? N Z Med J 2007;120:U2780.

Berends HI, Nijlant JM, Movig KL, Van Putten MJ, Jannink MJ, Ijzerman MJ. The clinical use of drugs influencing

eurotransmitters in the brain to promote motor recovery after stroke; a Cochrane systematic review. Eur J Phys Rehabil Med 2009;45:621-30.

Mead GE, Hsieh CF, Lee R, Kutlubaev MA, Claxton A, Hankey GJ, etal. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane Database Syst Rev 2012;14:11. http://dx.doi.org/10.1002/14651858. CD009286.pub2 DOI: https://doi.org/10.1002/14651858

Mead GE, Hsieh CF, Lee R, Kutlubaev M, Claxton A, Hankey GJ, et al. Selective serotonin reuptake inhibitors for stroke recovery: a systematic review and meta-analysis. Stroke 2013;44:844-50. http://dx.doi.org/10.1161/STROKEAHA.112.673947 DOI: https://doi.org/10.1161/STROKEAHA.112.673947

Marquez-Romero JM, Arauz A, Ruiz-Sandoval JL, Cruz-Estrada EL, Huerta- Franco MR, Aguayo-Leytte G, et al. Fluoxetine for motor recovery after acute intracerebral hemorrhage (FMRICH): study protocol for a randomized, double-blind, placebo-controlled, multicenter trial. Trials 2013;14:77. http://dx.doi.org/10.1186/1745-6215-14-77 DOI: https://doi.org/10.1186/1745-6215-14-77

Mostert JP, Koch MW, Heerings M, Heersema DJ, De Keyser J. Therapeutic potential of fluoxetine in neurological disorders. CNS Neurosci Ther 2008;14:153-64. http://dx.doi.org/10.1111/j.1527-3458.2008.00040.x DOI: https://doi.org/10.1111/j.1527-3458.2008.00040.x

Majeed F, Kamal AK. Can selective serotonin reuptake inhibitors (SSRI) improve motor recovery after stroke? What is the role of neuroplasticity? J Pak Med Assoc 2011;61:1147-8.

Gaillard R, Mir O. Fluoxetine and motor recovery after ischaemic stroke. Lancet Neurol 2011;10:499. http://dx.doi.org/10.1016/S1474-4422(11)70111-9 DOI: https://doi.org/10.1016/S1474-4422(11)70111-9

Robinson RG, Adams HP. Selective serotonin-reuptake inhibitors and recovery after stroke. Lancet Neurol 2011;10:110-1. http://dx.doi.org/10.1016/S1474-4422(10)70326-4 DOI: https://doi.org/10.1016/S1474-4422(10)70326-4

Mortensen JK, Larsson H, Johnsen SP, Andersen G. Post stroke use of selective serotonin reuptake inhibitors and clinical outcome among patients with ischemic stroke: a nationwide propensity score-matched follow-up study. Stroke 2013;44:420-6. http://dx.doi.org/10.1161/STROKEAHA.112.674242 DOI: https://doi.org/10.1161/STROKEAHA.112.674242

Li WL, Cai HH, Wang B, Chen L, Zhou QG, Luo CX, et al. Chronic fluoxetine treatment improves ichemia-induced spatial cognitive déficits through increasing hippocampal neurogenesis after stroke. J Neurosci Res 2009;87:112-22. http://dx.doi.org/10.1002/jnr.21829 DOI: https://doi.org/10.1002/jnr.21829

Gonzenbach RR, Taegtmeyer AB, Luft A, Russmann S. Fluoxetine and motor recovery after ischaemic stroke. Lancet Neurol 2011;10:499-500. http://dx.doi.org/10.1016/S1474-4422(11)70112-0 DOI: https://doi.org/10.1016/S1474-4422(11)70112-0

Nau JY. CVA: new indication for Prozac? Rev Med Suisse 2011;7:370-1.

Published

2015-06-30

Issue

Section

Revisão de Literatura

How to Cite

1.
Luvizutto GJ, Bazan R, Braga GP, Kuster GW, Lange MC, Zetola VF. Effects of serotonin reuptake inhibitors in neuronal plasticity after stroke. Rev Neurocienc [Internet]. 2015 Jun. 30 [cited 2026 Nov. 11];23(2):291-6. Available from: https://periodicos.unifesp.br/neurociencias/article/view/8035