Treatment of depressive disorders in neurological rehabilitation: Effects of paroxetine

Objective: Depression is a common problem in neurological rehabilitation. Although three double-blind studies have shown the efficacy of trazodone, citalopram and nortriptyline, antidepressant drug therapy of poststroke depression is not yet considered a state-of-the-art strategy. In a hospital for neurological rehabilitation we have performed an open study on the effects of the SSRI, paroxetine, in depressive disorders caused by neurological diseases. Method: 111 consecutive admissions were screened for depression and 9 patients were admitted to the study having a HDRS score greater than or equal to 14. Results: 10-40 mg of paroxetine were well tolerated and led to a greater than or equal to 50 % reduction of the HDRS score in 8/9 patients. A patient with pathological crying, but without depression, was also successfully treated with 20 mg of paroxetine. Conclusions: We conclude that the SSRI, paroxetine, is an effective and well-tolerated therapy of depressive disorders caused by various neurological diseases, including also other diagnoses than stroke.