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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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REVIEWS  UPDATE ON DRUGS IN STROKE REHABILITATION


European Journal of Physical and Rehabilitation Medicine 2013 April;49(2):261-7

lingua: Inglese

Safety in pharmacological enhancement of stroke rehabilitation

Engelter S. T. 1, 2

1 Neurorehabilitation Unit, Geriatric Competence Center, Felix Platter-Spital, Basel, Switzerland;
2 Stroke Unit and Neurological Department, University Hospital Basel, Basel, Switzerland


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Pharmacological enhancement of neurorehabilitation is based on the concept of neuroplasticity. Agents with probably unfavourable effects on recovery (e.g. classical antiepileptic drugs, butyrophenones) should be avoided. The findings of experimental studies in animal models, investigations in healthy subjects and the findings of neurophysiological studies indicate that there is scope for benefit from pharmacological enhancement in stroke rehabilitation in the clinical setting - in addition to rehabilitative therapies. Randomized controlled clinical trials have shown benefit of pharmacological enhancement in stroke rehabilitation for some agents. Nevertheless, the clinical evidence regarding benefits of this treatment approach is still considered weak for the following reason: First, the beneficial findings of some studies were not confirmed by others. Second, several studies were limited by small patient populations and narrow inclusion criteria. Third, there were concerns regarding safety of some agents (i.e., piracetam, and amphetamines). Dopaminergic agents, Selective Serotonin-Reuptake-Inhibitors (SSRI) and acetylcholinesterase-inhibitors are promising candidates. Their safety and efficacy should be further investigated; ideally in – sufficiently powered – large randomized controlled trials.

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stefan.engelter@fps-basel.ch