Escitalopram Improves Cognition Function in the Ischemic Stroke Patients

Cognition impairment is a common manifestation of ischemic stroke patients. The cognition function is modulated by serotonin levels in the brain. The serotonin levels of brain are changed during ischemic stroke. Therefore, we hypothesis that intervention in serotonin reuptake may improve the cognition function in the patients. We evaluated and compared the effect of escitalopram and fluoxetine on ischemic stroke patients. 

A hundred patients whose ischemic stroke was confirmed by neurologist were enrolled in this interventional study at Imam Khomeini Hospital, Urmia, Iran. All treatments and interventions performed based on a standard approach. The first group received escitalopram(10 mgd/day) as an adjuvant treatment and second group received fluoxetine (10 mgd/day). The cognition function of the patients was measured by Dementia Rating Scale (DRS) in the 5th and 95th days after final diagnosis.  Statistical analysis was carried out using IBM SPSS Statistics software version 23.

In this study about 54.1% of patients were female and the rest 45.9% were male.  Gender and smoking had no influence on cognition function. There was no difference in the cognition function of the patients with posterior and anterior circulation impairment. Our finding showed escitalopram but not fluoxetine improved the cognition function significantly (p=0.032). Age and creatinine levels had a significant correlation with cognition function before(DRS1) and after (DRS2) treatment and with their difference(DRS2-DRS1). While serum urea levels were correlated with the difference of DRS before and after treatment ( Pearson correlation, -.318, -.397 and P= 0.026, 0.005 respectively)

The results of this study recommends that escitalopram can be used as an adjuvant medicine to improve the cognition function in the ischemic stroke patients. The creatinine and urea levels may be a good biomarker to prescribe escitalopram in the ischemic stroke patients.