Efeito dos inibidores de recaptação da serotonina na plasticidade neural após acidente vascular cerebral

Abstract

Introduction. Recently, selective serotonin reuptake inhibitors (SSRIs) have been highlighted as neuroplasticity agents for improving functional and motor recuperation in patients after stroke. Objective. Considering the availability of these drugs in our context, even in the public healthcare system, we aimed to undertake a review of the literature in order to improve the decision-making process. Method. The review, based on data up to February 2013,included studies that took into account neuroprotective and anti-fatigue properties, and effect on motor recuperation capacity after stroke. Results. The control and randomized studies (RCT) found: motor recuperation improvement with the use of Fluoxetine, evaluated by the Fugl-Meyer Motor Scale after 90 days of treatment; improvement of functional independence, by modified Rankin scale and Barthel’s index, with the use of Nortriptyline; greater activation in the contralateral sensory-motor cortex after the use of paroxetine and no positive effect on the control of fatigue after stroke. Conclusion. The studies suggest better functional and motor recuperation with SSRI use. It was not possible to determine a difference among the agents, since the available studies are not comparative and were tested with different drugs; these and other gaps are being addressed by ongoing studies.