HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kimura, M. Articles by Robinson, R. G. Search for Related Content PubMed PubMed Citation Articles by Kimura, M. Articles by Robinson, R. G.

Treatment of Poststroke Generalized Anxiety Disorder Comorbid With Poststroke Depression

Merged Analysis of Nortriptyline Trials

Received November 2, 2001; revised January 16, February 7, 2002; accepted February 7, 2002. From the Department of Psychiatry, The University of Iowa College of Medicine, Iowa City, IA (MK,AT,RGR) and the Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan (MK,AT). Address correspondence to Robert G. Robinson, M.D., Department of Psychiatry, The University of Iowa, 200 Hawkins Dr., 2887 JPP, Iowa City, IA 52242. e-mail: robert-robinson{at}uiowa.edu
©2003 American Association for Geriatric Psychiatry

Objective: The existence of anxiety disorders plays an important role in the prognosis and associated impairment among patients with poststroke depression. The authors examined the efficacy of nortriptyline treatment for patients with comorbid generalized anxiety disorder (GAD) and depression after stroke. Methods: Data from three studies were merged to provide 27 patients with comorbid GAD and depression, who participated in double-blind treatment studies comparing nortriptyline (N=13) and placebo (N=14). Severity of anxiety was measured with the Hamilton Rating Scale for Anxiety (Ham-A), and severity of depression was measured with the Hamilton Rating Scale for Depression (Ham-D). Activities of daily living were assessed by use of the Johns Hopkins Functioning Inventory (JHFI). Results: There were no significant differences between the nortriptyline and placebo groups in demographic characteristics, stroke type, and neurological findings. Patients receiving nortriptyline treatment showed significantly greater improvement on the Ham-A, Ham-D, and JHFI than patients receiving placebo. The anxiety symptoms showed earlier improvement than depressive symptoms in patients treated with nortriptyline. Conclusions: These findings suggest that poststroke GAD comorbid with poststroke depression may be effectively treated with nortriptyline, and data indicate the need for a trial specifically designed to examine treatment of anxiety disorder.

Key Words: generalized anxiety disorder • stroke • poststroke depression • nortriptyline

This article has been cited by other articles:

				R. G. Robinson, R. E. Jorge, D. J. Moser, L. Acion, A. Solodkin, S. L. Small, P. Fonzetti, M. Hegel, and S. Arndt Escitalopram and Problem-Solving Therapy for Prevention of Poststroke Depression: A Randomized Controlled Trial JAMA, May 28, 2008; 299(20): 2391 - 2400. [Abstract] [Full Text] [PDF]

				J. G. Fiedorowicz, K. Takezawa, and R. G. Robinson Risk Factors for and Correlates of Poststroke Depression Following Discontinuation of Antidepressants J Neuropsychiatry Clin Neurosci, November 1, 2007; 19(4): 399 - 405. [Abstract] [Full Text] [PDF]

				M. Pinquart and P. R. Duberstein Treatment of Anxiety Disorders in Older Adults: A Meta-analytic Comparison of Behavioral and Pharmacological Interventions Am J Geriatr Psychiatry, August 1, 2007; 15(8): 639 - 651. [Abstract] [Full Text] [PDF]