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Evidence summaries

Gamma Aminobutyric Acid (Gaba) Receptor Agonists for Acute Stroke

GABA receptor agonists (chlormethiazole or diazepam) appear not to be effective for the treatment of acute ischemic or hemorrhagic stroke. Level of evidence: "B"

Summary

A Cochrane review [Abstract] 1 included 5 studies with a total of 3838 patients with acute ischemic or hemorrhagic stroke. All participants were included within 12 hours after stroke onset. Four trials (n=2909) measured death and dependency at 3 months in chlormethiazole vs. placebo without significant difference (RR 1.03, 95% CI 0.95 to 1.11). One trial (n=849) measured this outcome between diazepam and placebo without differences (RR 0.94, 95% CI 0.82 to 1.07). In the subgroup analysis of total anterior circulation syndrome (TACS, n=545), a higher percentage of functional independence was found in the chlormethiazole group (RR 1.33, 95% CI 1.09 to 1.64). The frequent adverse events related to chlormethiazole were somnolence (RR 4.56, 95% CI 3.50 to 5.95) and rhinitis (RR 4.75, 95% CI 2.67 to 8.46).

Comment: The quality of the evidence is downgraded by study quality (unclear allocation concealment).

Clinical comments

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    References

    • Liu J, Zhang J, Wang LN. Gamma aminobutyric acid (GABA) receptor agonists for acute stroke. Cochrane Database Syst Rev 2018;10():CD009622. [PubMed]

Primary/Secondary Keywords