A Cochrane review [Abstract] 1 included 14 studies with a total of 1 515 subjects. Data were available for 10 pharmaceutical trials (12 comparisons) and four psychotherapy trials. Pharmacological interventions included SSRIs (fluoxetine, sertraline), trazodone, piracetam, maprotiline, mianserin, nortriptyline, indeloxazine and methylphenidate. Varying forms of psychotherapy were used in the included trials (problem-solving therapy, broadly defined home-based therapy, motivational interviewing). The time from stroke to entry ranged from a few hours to seven months, but most patients were recruited within one month of acute stroke. The duration of treatment ranged from two weeks to one year. There was no clear effect of pharmacological therapy on the prevention of depression or other endpoints. A significant improvement in mood and the prevention of depression was evident for psychotherapy, but the treatment effects were small.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes)
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