Neuropsychiatric Presentations of Stroke

Question 1

What outcomes are associated with neuropsychiatric sequelae in stroke?

Answer 1

▪️ Greater disability
▪️ Worse recovery
▪️ Decreased quality of life

Question 2

What are the most common post-stroke neuropsychiatric conditions?

Answer 2

▪️ Delirium (13-48%)
▪️ Depression (35%)
▪️ Emotional incontinence
▪️ Anxiety and PTSD
▪️ Personality change - aggressive or apathetic
▪️ Pathological affect

Question 3

What can be used to treat depression post-stroke?

Answer 3

▪️ Antidepressants (SSRIs)
▪️ Psychotherapy

Question 4

What can be used to treat anxiety post-stroke?

Answer 4

▪️ Antidepressants (SSRIs)
▪️ Benzodiazepines
▪️ Pregabalin
▪️ Buspirone
▪️ Psychotherapy
▪️ Lifestyle modifications

Question 5

What can be used to treat PTSD post-stroke?

Answer 5

▪️ Exposure psychotherapy
▪️ Learning coping skills

Question 6

What can be used to treat aggressive personality change post-stroke?

Answer 6

▪️ SSRIs (fluoxetine)
▪️ Neuroleptics (haloperidol or atypical)
▪️ Antiepileptic drugs or beta blockers

Question 7

What can be used to treat apathetic personality change post-stroke?

Answer 7

▪️ Dopaminergic agents
▪️ Bupropron
▪️ Noradrenergic antidepressants
▪️ Nefiracetam
▪️ Cholinergic agents
▪️ Stimulants