Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Several clinical studies have indicated that selective serotonin reuptake inhibitors (<jats:styled-content style="fixed-case">SSRI</jats:styled-content>s) administered in patients after acute ischemic stroke can improve clinical recovery independently of depression. Due to small sample sizes and heterogeneous study designs interpretability was limited in these studies. The mechanisms of action whereby <jats:styled-content style="fixed-case">SSRI</jats:styled-content> might improve recovery from acute ischemic stroke are not fully elucidated.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched <jats:styled-content style="fixed-case">MEDLINE</jats:styled-content> using the PubMed interface to identify evidence of <jats:styled-content style="fixed-case">SSRI</jats:styled-content> mediated improvement of recovery from acute ischemic stroke and reviewed the literature on the potential underlying mechanisms of action.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among identified clinical studies, a well‐designed randomized, double‐blind, and placebo‐controlled study (<jats:styled-content style="fixed-case">FLAME</jats:styled-content> ‐ fluoxetine for motor recovery after acute ischemic stroke) demonstrated improved recovery of motor function in stroke patients receiving fluoxetine. The positive effects of <jats:styled-content style="fixed-case">SSRI</jats:styled-content>s on stroke recovery were further supported by a meta‐analysis of 52 trials in a total of 4060 participants published by the Cochrane collaboration. Based on animal models, the mechanisms whereby <jats:styled-content style="fixed-case">SSRI</jats:styled-content>s might ameliorate functional and structural ischemic‐brain damage were suggested to include stimulation of neurogenesis with migration of newly generated cells toward ischemic‐brain regions, anti‐inflammatory neuroprotection, improved regulation of cerebral blood flow, and modulation of the adrenergic neurohormonal system. However, to date, it remains speculative if and to what degree these mechanisms convert into humans and randomized controlled trials in large populations of stroke patients comparing different <jats:styled-content style="fixed-case">SSRI</jats:styled-content>s are still lacking.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In addition to the need of comprehensive‐clinical evidence, further elucidation of the beneficial mechanisms whereby <jats:styled-content style="fixed-case">SSRI</jats:styled-content>s may improve structural and functional recovery from ischemic‐brain damage is needed to form a basis for translation into clinical practice.</jats:p></jats:sec>