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Increased Lower Limb Spasticity but Not Strength or Function Following a Single-Dose Serotonin Reuptake Inhibitor in Chronic Stroke. Arch Phys Med Rehabil 2015 Dec;96(12):2112-9



Pubmed ID





OBJECTIVE: To investigate the effects of single doses of a selective serotonin reuptake inhibitor (SSRI) on lower limb voluntary and reflex function in individuals with chronic stroke.

DESIGN: Double-blind, randomized, placebo-controlled crossover trial.

SETTING: Outpatient research setting.

PARTICIPANTS: Individuals (N=10; 7 men; mean age ± SD, 57±10y) with poststroke hemiplegia of >1 year duration who completed all assessments.

INTERVENTIONS: Patients were assessed before and 5 hours after single-dose, overencapsulated 10-mg doses of escitalopram (SSRI) or placebo, with 1 week between conditions.

MAIN OUTCOME MEASURES: Primary assessments included maximal ankle and knee isometric strength, and velocity-dependent (30°/s-120°/s) plantarflexor stretch reflexes under passive conditions, and separately during and after 3 superimposed maximal volitional drive to simulate conditions of increased serotonin release. Secondary measures included clinical measures of lower limb coordination and locomotion.

RESULTS: SSRI administration significantly increased stretch reflex torques at higher stretch velocities (eg, 90°/s; P=.03), with reflexes at lower velocities enhanced by superimposed voluntary drive (P=.02). No significant improvements were seen in volitional peak torques or in clinical measures of lower limb function (lowest P=.10).

CONCLUSIONS: Increases in spasticity but not strength or lower limb function were observed with single-dose SSRI administration in individuals with chronic stroke. Further studies should evaluate whether repeated dosing of SSRIs, or as combined with specific interventions, is required to elicit significant benefit of these agents on lower limb function poststroke.

Author List

Gourab K, Schmit BD, Hornby TG


Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University

MESH terms used to index this publication - Major topics in bold

Chronic Disease
Cross-Over Studies
Double-Blind Method
Middle Aged
Muscle Spasticity
Muscle Strength
Range of Motion, Articular
Serotonin Uptake Inhibitors
Stroke Rehabilitation