What are the effects of pharmacological, non-invasive brain stimulation and psychological interventions, and their combination, in the treatment of post-stroke depression? A Cochrane Review summary with commentary

NeuroRehabilitation. 2024;54(3):505-508. doi: 10.3233/NRE-246003.

Abstract

Background: Post-stroke depression (PSD) is a prevalent condition that can significantly influence the recovery process.

Objective: To assess the effects of pharmacological, non-invasive brain stimulation and psychological interventions, and their combination on PSD.

Methods: A summary of the Cochrane Review by Allida et al. (2023), with comments from a rehabilitation perspective.

Results: Sixty-one studies with 5831 participants were included in the Cochrane Review. Very low-certainty evidence indicated favorable treatment effects of pharmacological interventions, psychological therapies, and the combination of pharmacological intervention and non-invasive brain stimulation on PSD. Pharmacological intervention has resulted in increased side effects associated with the central nervous system and gastrointestinal system, with very low-certainty evidence.

Conclusion: Evidence for the effectiveness of pharmacological, psychological, and combination therapies for the management of PSD is uncertain, as the quality of the evidence has been assessed as very low. Therefore, further studies with improved methods should investigate pharmacological and non-pharmacological interventions for the treatment of depression in stroke survivors.

Keywords: Depression; drug intervention; non-invasive brain stimulation; psychological intervention; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Combined Modality Therapy
  • Depression* / drug therapy
  • Depression* / etiology
  • Depression* / therapy
  • Humans
  • Psychosocial Intervention / methods
  • Psychotherapy / methods
  • Stroke Rehabilitation / methods
  • Stroke* / complications
  • Stroke* / psychology

Substances

  • Antidepressive Agents