| BackgroundAs one of the common complications of stroke ,post-stroke depression (PSD) takes both mental and physical burdens for patients. Selective serotonin reuptake inhibitors (SSRIs) are widely used in the clinical treatment of depression for its specific receptor blocking effect on serotonin receptors, In recent years, more and more studies showed that, SSRIs can both alleviate depressed emotions and improve motor functions recovery, however, whether there is an exact clinic effect for PSD, there is no consistent opinions right now. This research aimed at conducting a systematic reviews on the domestic and foreign relevant randomized controlled clinical studies(RCTs), to discuss the feasibility of SSRIs in treating PSD.Objects1.Evaluating the function of SSRIs in improving depressed mood and alleviating motor function deficient in PSD patients.2.Discussing the safety of SSRIs antidepressants in treating PSD.Methods1.A search was conducted in Cochrane Library, MEDLINE, Pubmed, EMbase, VIP, Wanfang database, CBM. To retrieve all RCTs of SSRIs in the treatment of PSD;2.Screened the literatures according to the inclusion and exclusion criteria, extracting the primary data;3.Assessed the quality of literatures witch met the inclusion criteria;4.The quality of the included trials was assessed and meta-analysis was conducted by RevMan 5.2 software.Results1.Outcome of Depression Scale scores:1.1 The experimental group and the control group HAMD depression scale scores results suggest that SSRIs antidepressants can improve depressed emotionin patients with PSD,the difference was statistically significant[MD=-6.53,95%C/(-8.05,-5.01), P<0.000 01];1.2 The self-control analysis results of Intervention group showed that SSRIs could reduce the PSD patient Depression Scale score significantly, means that SSRIs depressed emotion in patients with PSD could be effectively improved, and the difference was statistically significant[MD=-12.86,95% CI(-14.15,-11.57), P<0.00001];1.3 The reducing rate outcomes of Depression scale showed that the number of patients arrived the leavel of curative, significant effective and effective in intervention group are more than the control group, the differences was statistically significant[cure rate:RR=3.91,95% CI (2.73,5.60), P<0.00001; significant efficiency rate:RR=2.21,95% CI(1.90,2.57), P<0.00001; effective rate:RR=1.59,95% CI(1.44,1.76), P<0.00001];2. Stroke Scale score results:2.1 The results of intervention group and the control group Stroke Scale scores suggested that SSRIs antidepressants could improve deficient of neurological function in PSD patients, conduce patients’motor function recovery, the difference was statistically significant[SMD=-1.53,95%CI(-2.08,-0.99), P<0.00001];2.2 The self-control analysis results of Intervention group showed that SSRIs antidepressants could improve neurological deficits of PSD patients effectively, and the difference was statistically significant[MD=-3.34,95%CI(-4.24,-2.45), P<0.00001];2.3 Stroke Scale reducing rate outcomes showed that Stroke Scale scores reducting rate in the intervention groups were better than in the control groups, means that SSRIs may improve neurological deficits of PSD patients, the difference was statistically significant[cure rate:RR=1.88,95%CI(1.34,2.64), P=0.0003; significant efficiency rate:RR=1.63,95%CI(1.36,1.95), P<0.00001; efficiency rate:RR=1.28,95%CI(1.14,1.43), P<0.00001].3. Adverse effect:3.1 Common adverse effects in included studies appeared that the incidence rate of dry mouth in intervention group were higher, and incidence rate on insomnia, headache, dizziness, loss of appetite,nausea and vomiting, constipation, sweating were equal,there was no significant difference [dry mouth:RR=3.75,95%CI(1.81,7.75), P=0.0004;Insomnia :RR=1.47,95%CI(0.85,2.54), P=0.17; headache:RR=1.69,95%CI(0.87,3.27), P=0.12; dizziness:RR=0.91,95%CI(0.44,1.90), P=0.81; nausea and vomiting:RR=1.60,95%CI (0.94,2.74), P=0.08; loss of appetite:RR=1.80,95% CI(0.91,5.56), P=0.03; constipation: RR=2.05,95%CI(0.84,4.99), P=011; sweating:RR=1.15,95%CI(0.54,2.42), P=0.72].Conclusions1.SSRIs could not only improve the depressed emotion with PSD patients, but can promote the recovery of neurological function effectively;2.SSRIs are safe, it’s appropriate for using it on the treatment of PSD. |
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