Psychology Research and Behavior Management (Jul 2022)
A Narrative Review on the Non-Pharmacologic Interventions in Post-Stroke Depression
Abstract
Tissa Wijeratne,1– 3 Carmela Sales,4 Chanith Wijeratne5 1School of Psychology and Public Health, La Trobe University, Melbourne, Australia; 2Department of Neurology, Western Health & University Melbourne, AIMSS, Level Three, WHCRE, Sunshine Hospital, St Albans, 3021, Australia; 3Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka; 4Department of Medicine and Neurology, AIMSS, Melbourne Medical School, Sunshine Hospital, Western Health, St. Albans, Victoria, Australia; 5Monash Medical School, Clayton, Victoria, AustraliaCorrespondence: Tissa Wijeratne, Email [email protected]: Stroke is a major cause of death and disability globally. Post-stroke depression (PSD) is a major driver for poor recovery and poor quality of life with extra burden for the patient and the caregiver. We have previously shown the inflammatory basis of PSD with associated bioenergetic failure, disruption of the blood-brain barrier, cell death, and persistent maladapted inflammation, making the PSD a norm rather than the exception, highlighting the unmet need for therapeutic intervention in PSD across the recovery trajectory. In this era, various interventions are focused on pharmacotherapy; however, non-pill-based medication should also be explored as post-stroke patients are likely to suffer from the adverse effects of polypharmacy. This narrated review explores the status of non-pharmacological interventions in managing PSD. We performed a PubMed search using pre-specified keywords looking at various non-pharmacologic approaches for the management of PSD. Worldwide, approaches such as non-invasive brain stimulation, behavioral and psychosocial therapy, as well as exercise, acupuncture, music, literature, and art therapies are available as monotherapy or adjunctive treatment for PSD. While current literature shows convincing results on the benefits of non-pharmacologic interventions, more robust studies are necessary to determine its utility in PSD.Keywords: stroke, depression, non-pharmacological intervention, disability
