This study aimed to investigate whether the routine
administration of
escitalopram for three months would improve the
prognosis of
patients with
ischemic stroke and decrease the
plasma copeptin level. A total of 97
patients with acute
cerebral infarction were randomly allocated to receive
escitalopram (5-10 mg once per day, orally; n=49) or not to receive
escitalopram (
control group; n=48) for 12 weeks starting at 2-7 days after the onset of
stroke. Both groups received conventional
treatments, including physiotherapy and
secondary prevention of
stroke. The
National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the disability of
patients at the initial evaluation and at the monthly follow-up visits for three months. Impairment in the daily activities was assessed using the Barthel Index (BI), while
cognitive impairment was assessed using Mini-Mental
State Examination (MMSE) score. The psychiatric assessment included the
administration of the Present
State Examination modified to identify
Diagnostic and Statistical Manual of Mental Disorders (
DSM-IV) symptoms of
depression. The severity of
depression was measured using the 17-item Hamilton Rating Scale for
Depression (HAMD). During the 3-month follow-up period, 95
patients were included in the
analysis (two
patients withdrew from the
escitalopram group). NIHSS and BI improvement at the 90th day were significantly greater in the
escitalopram group (P<0.05), while HAMD and
plasma copeptin levels significantly decreased, compared to the
control group (P<0.01). In
patients with
acute ischemic stroke, the earlier
administration of
escitalopram for three months may improve neurological functional
prognosis and decrease copeptin level.