Question:
I had a stroke in 2001 at 40 years old which damaged my
balance and short term memory. I'm now 43, retired on
social security and can't shake my depression since.
Prozac after 1 year didn't make a difference. I was
told the stroke was caused by radiation therapy damage
after a brain tumor removal from the cerebellum in
1981. Do you think the radiation therapy from 20 years+
ago may have also done physical damage to cause may
unshakable depression? Do you have suggestions on how
I can feel better? I exercise at a gym religiosly 3+
days a week which helps bring my mood up to medium then
falls until I exercise again?
Thanks
Dr. Heller's Answer:
Assuming you didn't have mental health problems before
the stroke AND that you have no active coronary artery
disease, there's a moderate chance psychostimulants
like Ritalin and Adderall can make a difference. While
the scientific literature is sketchy, I've seen it work
on many stroke patients.
Here are some references that don't prove the point but
show it might help:
Methylphenidate in early poststroke recovery: a double
blind, placebo controlled study.
Arch Phys Med Rehab 1998 Sep
"Methylphenidate appears to be a safe and effective
intervention in early poststroke rehabilitation that
may expedite recovery."
Effects of methylphenidate on attentional function
after traumatic brain injury. A
randomized, placebo-controlled trial.
Am J Phys Med Rehabil 1997 Nov-Dec
"Methylphenidate produced a significant improvement in
the speed of mental processing. Most
aspects of sustained attention, and measures of motor
speed were unaffected. Methylphenidate may
be a useful treatment of traumatic brain injury, but is
primarily useful for symptoms that can be
attributed to slowed mental processing."
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