Selective Serotonin Reuptake Inhibitors

Selective Serotonergic Reuptake Inhibitors (SSRIs) are a class of medications used frequently to address issues related to stroke and post-stroke recovery. Health care providers who care for stroke patients will need to familiarize themselves with their applications in stroke treatment. These medications are primarily used to treat depression but have been used in other conditions including pain management. While initial evidence from the FLAME trial suggested that SSRIs may facilitate motor recovery after a stroke through neuroplastic mechanisms, more recent trials seem to contradict this. This chapter will review the uses and indications in stroke survivors and examine the evidence to support those indications. The chapter begins with a general review of the SSRI class of medication with a focus on the pharmacology as well as its indications in non-stroke-related conditions. We will then highlight the data for the overall effects of SSRIs on outcomes in stroke patients, along with evidence for us for post-stroke depression, motor recovery, pain syndromes, and other post-stroke conditions.