84033
document
Citalopram for post-stroke pathological crying . Post-stroke pathological crying is a distressing condition in which episodes occur in response to minor stimuli without associated mood changes . There is preliminary evidence of disturbed serotoninergic neurotransmission in such cases . We investigated the effect of the selective serotonin reuptake inhibitor citalopram on uncontrolled crying in stroke patients in a double-blind placebo-controlled crossover study . 16 consecutive patients ( median age 58.5 years , range 40-83 ) entered the 9-week study a median of 168 days ( range 6-913 ) post stroke and were treated with citalopram 10-20 mg daily for 3 weeks . Crying history was determined from semistructured interviews and from diaries kept by the patients . Psychiatric assessment was made with the Hamilton depression scale ( HDS ) , and unwanted effects were measured with the UKU side-effect scale . In 13 patients in whom frequency of crying could be assessed , the number of daily crying episodes decreased by at least 50 % in all cases during citalopram treatment vs 2 patients during placebo treatment ( p < 0.005 , McNemar 's test ) , the effect being rapid ( 1-3 days ) and pronounced in 11 ( 73 % ) . There was a concomitant significant decrease in depression rating from HDS 8.9 to 5.3 ( p < 0.005 , Wilcoxon 's test ) . Citalopram was well tolerated , the few side-effects being mild and transient . We conclude that serotoninergic neurotransmission plays an important part in post-stroke pathological crying and that citalopram is an effective and well-tolerated treatment .
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Intervention_Pharmacological
Citalopram
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Intervention_Pharmacological
citalopram
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Intervention_Pharmacological
9-week study a median of 168 days ( range 6-913 ) post stroke and were treated with citalopram 10-20 mg daily for 3 weeks
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Intervention_Educational
Crying history was determined from semistructured interviews and from diaries kept by the patients
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Intervention_Pharmacological
citalopram
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Outcome_Physical
selective serotonin reuptake inhibitor citalopram
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Outcome_Mental
uncontrolled crying
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Outcome_Mental
Crying history
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Outcome_Mental
Psychiatric assessment
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Outcome_Mental
Hamilton depression scale
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Outcome_Adverse-effects
unwanted effects
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Outcome_Adverse-effects
UKU side-effect scale
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Outcome_Mental
frequency of crying
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Outcome_Mental
number of daily crying episodes
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Outcome_Mental
decrease in depression rating
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Participant_Condition
stroke
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Participant_Sample-size
16
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Participant_Age
58.5 years , range 40-83
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Participant_Condition
Crying history
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Participant_Sample-size
13
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Participant_Condition
crying