CONTACT: BECKY SOGLIN
Iowa City IA 52242
(319) 335-6660; fax (319) 384-4638
Release: Dec. 4, 2002
(Photo: Robert G. Robinson, M.D., the Paul W. Penningroth Chair and head
of psychiatry and the study's lead investigator.)
UI receives NIMH grant to study prevention of post-stroke depression
National Institute of Mental Health has awarded University of Iowa Health
Care researchers a five-year, nearly $3.7 million grant to study whether preventive
treatment helps ward off depression in people who have had a stroke. Previous
UI and other research provided evidence that reducing or eliminating depression
may significantly reduce the chances of post-stroke complications or even
Depression within days after a stroke currently affects approximately 40
percent of the nearly 400,000 individuals in the United States who annually
survive a stroke. Another 25 percent of survivors develop depression within
two years of their stroke.
Because stroke, including related complications, is the third leading cause
of death in adults in the United States, reducing the death rate by 50 percent
would help save hundreds of thousands of lives, said Robert G. Robinson, M.D.,
the Paul W. Penningroth Chair and head of psychiatry and the study's lead
"This study will attempt to answer the most important question that
remains in post-stroke depression treatment and that is whether prophylactic,
or preventive, antidepressant treatment should be given to all stroke patients,"
Robinson said. "Our previous research suggests it will help their recovery
from stroke by decreasing emotional, physical, cognitive, and even fatal consequences
The study will focus on non-depressed stroke patients within the first three
months of their stroke. During the first year of their participation in the
study, patients will receive psychotherapy, a medication called escitalopram
or a placebo (inactive pill).
Any patients who develop depression that lasts two weeks or longer during
the study period will be screened and taken out of the study so that their
depression can be appropriately treated. The remaining, non-depressed study
participants will then be followed for another six months before the researchers
analyze the findings.
Previous UI studies showed that post-stroke depression within the first
year after a stroke can significantly decrease a person's ability to recover
cognitive skills such as attention and memory, as well as abilities for daily
tasks such as washing and dressing. However, treatment that improves the mood
of people with depression following stroke appears to help them feel better
emotionally and physically and improve their mental abilities.
Previous data also indicate that antidepressant treatment for post-stroke
patients, whether they have depression or not, cuts their risk of death by
more than half, Robinson said.
"This study has the potential to significantly impact the treatment
of patients with stroke because it would represent one of the most important
changes in the care of stroke patients since the introduction of clot-busting
drugs such as TPA," Robinson said. "It also is one of the first
times that we are focusing on a mental disorder and undertaking what really
is the goal of much of medicine -- prevention."
In addition to the UI, institutions participating in the study include the
University of Chicago Pritzker School of Medicine and the Joan and Sanford
I. Weill Medical College at Cornell University, which is participating through
the Burke Rehabilitation Hospital.
University of Iowa Health Care describes the partnership between
the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and
Clinics and the patient care, medical education and research programs and
services they provide. Visit UI Health Care online at www.uihealthcare.com.