Pharmacological Therapies to Enhance Motor Recovery and Walking After Stroke

Emerging Strategies

Wieslaw Oczkowski


Expert Rev Neurother. 2013;13(8):903-909. 

In This Article

Expert Commentary

Stroke unit care, acute and rehabilitation, improves outcomes for patients. The key components of a stroke unit include clustering patients and treatment by an expert stroke team. The treatments provided by the stroke teams are often complex in that they are multimodal, variable and often provided by more than one individual. The exact intervention and its impact on improvement are often difficult to identify.

Motor recovery and recovery of walking is one of the earliest and most obvious targets for intervention. Animal and human research suggests that strategies that are started early, are functional, and increased practice are more likely to lead to a better outcome. However, the timing, duration and the exact therapeutic programs have yet to be designed and tested before they can be put into general practice.

Preliminary randomized trials suggest that treatment with dopaminergic or SSRI medications may enhance motor recovery after stroke. It is tempting for clinicians to give these medications to patients on rehabilitation units, but they need to understand that by doing so they are using them 'off-label'. Although these medications are used commonly in patients with Parkinson's disease or patients with depression, they are not yet proven or approved for enhancing motor recovery after stroke. The best we can do at this time is to enroll our patients in clinical trials that are designed to test this new indication.