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Grethe Andersen - One of the best experts on this subject based on the ideXlab platform.

  • Prescription and predictors of post-stroke antidepressant treatment: A population-based study.
    Acta Neurologica Scandinavica, 2018
    Co-Authors: Janne Kaergaard Mortensen, Søren Paaske Johnsen, Grethe Andersen
    Abstract:

    OBJECTIVES: Post-stroke depression and Pathological Crying are common and potentially serious complications after stroke and should be diagnosed and treated accordingly. Diagnosis and treatment probably rely on clinical experience and may pose certain challenges. We aimed to examine prescription and predictors of antidepressant treatment after ischemic stroke in a clinical setting. MATERIALS AND METHODS: In this registry-based follow-up study, consecutive ischemic stroke patients were identified from the Danish Stroke Registry, holding information on antidepressant treatment during admission in Aarhus County from 2003 to 2010. Information on prescription after discharge was obtained from the Danish Prescription Database. Treatment initiation was analyzed using the cumulative incidence method including death as a competing risk. Multiple logistic regression was used to identify potential predictors of treatment. RESULTS: Among 5070 consecutive first-ever ischemic stroke patients without prior antidepressant treatment, the cumulative incidence of antidepressant treatment and prescription over 6 months was 35.2% (95% CI: 33.8-36.6). Overall 16.5% (95% CI: 15.5-17.6) started treatment within 14 days corresponding to 48.1% (95% CI: 45.8-50.5) of all treated patients, and the most widely prescribed group of antidepressants was selective serotonin reuptake inhibitors (86%). Increasing stroke severity was associated with higher odds of initiating treatment. CONCLUSION: Antidepressant treatment in this real-life clinical setting was common and initiated early, in almost half the treated patients within 14 days. Our results suggest that special focus should be given to the severe strokes as they may have a greater risk of requiring treatment.

  • Abstract T MP45: Incidence, Predictors And Mortality Related To Post-stroke Antidepressant Treatment
    Stroke, 2015
    Co-Authors: Janne Kaergaard Mortensen, Heidi Larsson, Søren Paaske Johnsen, Grethe Andersen
    Abstract:

    Objective: To examine incidence, predictors and mortality related to antidepressant treatment after ischemic stroke in a clinical setting. Methods: Patients were identified from the Danish Stroke Registry which holds information on antidepressant treatment due to post stroke depression (PSD) and Pathological Crying (PC) from 2003-2010. Treatment initiation and mortality were analyzed using Kaplan-Meier curves and Cox regression. Potential predictors of antidepressant treatment were identified using multiple logistic regression. Results: Among 5070 first ever stroke patients without prior antidepressant treatment, 32.5% were treated with antidepressants within six months after stroke, primarily with selective serotonin reuptake inhibitors. Approximately half of the treated patients started treatment during stroke admission (mean time after stroke: 7 days for PC and 10 days for PSD). The vast majority of treated patients started treatment within 90 days (86%). Among patients treated during admission 93.1% r...

  • Abstract W P139: Differential Impact of Preadmission Selective Serotonin Reuptake Inhibitor Treatment on Stroke Outcomes Among Ischemic and Hemorrhagic Stroke Patients? A Nationwide Propensity Score-Matched Follow-Up Study
    Stroke, 2014
    Co-Authors: Janne Kaergaard Mortensen, Grethe Andersen, Heidi Larsson, Søren Paaske Johnsen
    Abstract:

    Introduction: SSRIs are widely used for treating post-stroke depression and Pathological Crying and appear to have antithrombotic effects that may increase the risk of bleeding. Increasing evidence further suggests a neuroprotective effect in stroke, however clinical data are sparse. Aim and hypothesis: We aimed to examine the implications of pre-admission SSRI use in patients with ischemic and hemorrhagic stroke. We hypothesized a neuroprotective and antithrombotic effect leading to less severe strokes and decreased 30-day mortality among the ischemic strokes, and a possible reverse effect among the hemorrhagic strokes. Methods: We did a nationwide registry-based follow-up study among ischemic and hemorrhagic stroke patients in Denmark between 2003 and 2011. We identified 4348 pre-admission SSRI users (556 hemorrhagic strokes) and 4348 propensity score-matched non-users in the Danish Stroke Registry. Multiple conditional logistic regression was used to compute odds ratios (OR) of severe stroke (as measured on the Scandinavian Stroke Scale) and death within 30 days after stroke. Analyses were repeated after excluding patients with hemorrhagic stroke. Results: For the stroke types combined, pre-admission SSRI use was associated with a higher risk of severe stroke (adjusted OR, 1.12; CI, 1.00-1.25) and a non-significantly higher risk of death within 30 days (adjusted OR, 1.27; CI, 0.73-2.19). In contrast, no statistically significant difference in risk of severe stroke (adjusted OR, 1.06; CI, 0.92-1.21) or death within 30 days (adjusted OR, 0.81; CI, 0.38-1.77) was found between pre-admission SSRI-users and non-users after excluding patients with hemorrhagic stroke. Conclusion: Our results suggest that pre-admission SSRI use may be associated with a higher risk of severe stroke and case-fatality in patients with hemorrhagic stroke, but not in patients with ischemic stroke. Further studies are warranted to explore the possible neuroprotective and hemorrhagic effects of SSRI treatment in patients admitted with acute stroke.

  • serotonin 5ht1a receptor availability and Pathological Crying after stroke
    Acta Neurologica Scandinavica, 2007
    Co-Authors: Mette Moller, Grethe Andersen, Albert Gjedde
    Abstract:

    Objectives –  Post-stroke depression and Pathological Crying (PC) implicate an imbalance of serotonergic neurotransmission. We claim that PC follows serotonin depletion that raises the binding potential (pB) of the 5-HT1A receptor antagonist [carbonyl–11C]WAY-100635, which is reversible by selective serotonin re-uptake inhibitor (SSRI) treatment. Materials and Methods –  We PET scanned patients with acute stroke and PC and age-matched control subjects. Maps of receptor availability were generated from the images of eight cortical regions and raphe nuclei. Results –  The maps showed highest binding in limbic areas and raphe nuclei, while binding in basal ganglia and cerebellum was negligible. Baseline binding potentials of patients were lower than that of control subjects (3.7 ± 0.6 vs 4.2 ± 0.2). Treatment with SSRI markedly reduced free receptor sites, whereas placebo administration led to a global increase. Discussion –  The study is the first suggestion of changes of serotonergic neurotransmission in the early phase of stroke and the modulation of these changes with SSRI treatment.

  • Citalopram treatment of traumatic brain damage in a 6-year-old boy.
    Journal of Neurotrauma, 1999
    Co-Authors: Grethe Andersen, Mette Stylsvig, Niels Sunde
    Abstract:

    Traumatic brain damage may cause acute emotional symptoms such as uncontrolled Crying, apathy, and sleep problems. Rehabilitation may be less effective in patients afflicted by these symptoms. Citalopram, a selective serotonin reuptake inhibitor (SSRI), has a documented immediate and dramatic effect on Pathological Crying in stroke patients. The present case history of a 6-year-old boy with a traumatic right-sided hemorrhage in the basal ganglia indicates that early SSRI treatment has a dramatic effect on Pathological Crying and in addition may have a concomitant beneficial effect on motor paresis, sleep disturbance, and neurobehavioral problems.

J O Riis - One of the best experts on this subject based on the ideXlab platform.

  • pathoanatomic correlation between poststroke Pathological Crying and damage to brain areas involved in serotonergic neurotransmission
    Stroke, 1994
    Co-Authors: G Andersen, M Ingemannielsen, K Vestergaard, J O Riis
    Abstract:

    The aim of the study was to correlate the severity of poststroke Pathological Crying with lesion size and location. Twelve selected stroke patients were ranked in terms of overall clinical severity of the syndrome of Pathological Crying, and the size and location of the stroke lesion(s) were determined by magnetic resonance imaging. The patients with the clinically most severe Pathological Crying had relatively large bilateral pontine lesions without lesions in the hemispheres. The intermediate group had bilateral central hemispheric lesions, and the clinically least affected patients had mainly unilateral large subcortical lesions. Poststroke Pathological Crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brain stem or their ascending projections to the hemispheres.

  • citalopram for post stroke Pathological Crying
    The Lancet, 1993
    Co-Authors: G Andersen, K Vestergaard, J O Riis
    Abstract:

    Abstract 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

Georg Rieder - One of the best experts on this subject based on the ideXlab platform.

  • a simple collapse agitation and Pathological Crying in a young woman
    JVIN, 2015
    Co-Authors: Thorleif Etgen, Dragana Milankoviceberl, Georg Rieder
    Abstract:

    Background: A collapse and agitation in a young person comprises many differential diagnoses, but usually does not include a life-threatening basilar thrombosis. Methods and Results: We report the case of a 19-year old woman who presented mainly with a collapse and agitation. CT and CT-angiography yielded distal basilar thrombosis which was successfully treated by intraarterial thrombolysis. MRI confirmed multiple small ischemic lesions in the vertebrobasilar territory. The patient improved quickly and returned to her normal daily activities of life after a few months. Conclusions: Posterior circulation ischemia should be included among the possible differential diagnoses of any acute onset of an agitated or confusional state.

  • a simple collapse agitation and Pathological Crying in a young woman atypical onset of a basilar thrombosis
    Journal of vascular and interventional neurology, 2014
    Co-Authors: Thorleif Etgen, Dragana Milankoviceberl, Georg Rieder
    Abstract:

    BACKGROUND: A collapse and agitation in a young person comprises many differential diagnoses, but usually does not include a life-threatening basilar thrombosis. METHODS AND RESULTS: We report the case of a 19-year old woman who presented mainly with a collapse and agitation. CT and CT-angiography yielded distal basilar thrombosis which was successfully treated by intraarterial thrombolysis. MRI confirmed multiple small ischemic lesions in the vertebrobasilar territory. The patient improved quickly and returned to her normal daily activities of life after a few months. CONCLUSIONS: Posterior circulation ischemia should be included among the possible differential diagnoses of any acute onset of an agitated or confusional state. CONFLICTS OF INTEREST/DISCLOSURES: None to declare. ETHICS: Written informed consent of the patient has been obtained.

M Ingemannielsen - One of the best experts on this subject based on the ideXlab platform.

  • post stroke Pathological Crying frequency and correlation to depression
    European Journal of Neurology, 1995
    Co-Authors: Grethe Andersen, Karsten Vestergaard, M Ingemannielsen
    Abstract:

    : While Pathological Crying has classically been described as a disturbance of the motor concomitants of emotional affect that is unrelated to mood, recent studies indicate that there may in fact be a correlation. We therefore undertook a study of post-stroke Pathological Crying in relation to mood score/depression and lesion site in an unselected stroke population the first year following stroke. The study population comprised 211 patients with first ever stroke (median age 69 years, range 25-80). The patients were included in the study within 7 days of the onset of stroke, and follow-up examinations were made at 1 month, 6 months and 1 year. Computerized tomography brain scans were obtained on Days 5-10. The frequency of Pathological Crying was 14% at 1 month, 10% at 6 months and 11% at 1 year. The overall 1 year incidence was 19%. Pathological Crying correlated significantly to mood score and post-stroke depression (p < 0.005), as well as to lesion size (p < 0.05), Barthel Index (p < 0.05), Motricity Index (p < 0.005) and intellectual impairment (p < 0.05), but not to lesion location, sex, age, history of stroke or depression, predisposing disease or social distress before the stroke incident Post-stroke Pathological Crying was common and persistent in 11% of patients at 1 year and correlated strongly to mood score and post-stroke depression. The indication for treatment of Pathological Crying is therefore further strengthened.

  • pathoanatomic correlation between poststroke Pathological Crying and damage to brain areas involved in serotonergic neurotransmission
    Stroke, 1994
    Co-Authors: G Andersen, M Ingemannielsen, K Vestergaard, J O Riis
    Abstract:

    The aim of the study was to correlate the severity of poststroke Pathological Crying with lesion size and location. Twelve selected stroke patients were ranked in terms of overall clinical severity of the syndrome of Pathological Crying, and the size and location of the stroke lesion(s) were determined by magnetic resonance imaging. The patients with the clinically most severe Pathological Crying had relatively large bilateral pontine lesions without lesions in the hemispheres. The intermediate group had bilateral central hemispheric lesions, and the clinically least affected patients had mainly unilateral large subcortical lesions. Poststroke Pathological Crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brain stem or their ascending projections to the hemispheres.

G Andersen - One of the best experts on this subject based on the ideXlab platform.

  • Risk factors for post-stroke depression
    Acta Psychiatrica Scandinavica, 1995
    Co-Authors: G Andersen, K Vestergaard, M. Ingemann-nielsen, L. Lauritzen
    Abstract:

    An unselected cohort of 285 stroke patients, median age 69 years, were studied for correlation between potential risk factors and the 1-year incidence of post-stroke depression (PSD). The following factors correlated significantly with PSD: a history of previous stroke, a history of previous depression, female gender, living alone and social distress prestroke. Further, social inactivity, decrease in social activity, Pathological Crying and intellectual impairment at 1 month but not functional outcome correlated to PSD. A multivariate regression analysis showed that intellectual impairment explained 42% of variance of mood score. Major depression was unrelated to lesion location. We conclude that etiology to PSD is a complex mixture of prestroke personal and social factors, and stroke induced social, emotional and intellectual handicap.

  • pathoanatomic correlation between poststroke Pathological Crying and damage to brain areas involved in serotonergic neurotransmission
    Stroke, 1994
    Co-Authors: G Andersen, M Ingemannielsen, K Vestergaard, J O Riis
    Abstract:

    The aim of the study was to correlate the severity of poststroke Pathological Crying with lesion size and location. Twelve selected stroke patients were ranked in terms of overall clinical severity of the syndrome of Pathological Crying, and the size and location of the stroke lesion(s) were determined by magnetic resonance imaging. The patients with the clinically most severe Pathological Crying had relatively large bilateral pontine lesions without lesions in the hemispheres. The intermediate group had bilateral central hemispheric lesions, and the clinically least affected patients had mainly unilateral large subcortical lesions. Poststroke Pathological Crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brain stem or their ascending projections to the hemispheres.

  • citalopram for post stroke Pathological Crying
    The Lancet, 1993
    Co-Authors: G Andersen, K Vestergaard, J O Riis
    Abstract:

    Abstract 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