national-clinical-guidelines-for-stroke-fourth-edition

6.45.2 Sources
advice on factors to be taken into account when deciding on best interests and
recognising that relatives cannot make or determine healthcare decisions.
A www.justice.gov.uk/downloads/guidance/protecting-the-vulnerable/mca/
opg-603-0409.pdf
6.46 Drugs affecting recovery/reduction of impairment
After stroke, patients are often taking many drugs for a wide variety of reasons. Some of
these drugs could potentially limit recovery or performance. Others have been proposed
as enhancing recovery. This section gives recommendations based on the evidence
available. It only mentions drugs where some evidence is available, and inclusion or
failure to be mentioned in the recommendations carries no implications concerning
safety. There has been a recent small trial of fluoxetine reporting positive results (Chollet
et al 2011) but this needs confirmation with a larger trial before it can be recommended
for routine use.
6.46.1 Recommendations
A The following drugs should not be given with the goal of enhancing recovery outside
the context of clinical trials:
● amphetamines
● bromocriptine and other dopamine agonists
● piracetam
● meprobamate
● fluoxetine and other selective serotonin reuptake inhibitor (SSRI) antidepressants
● benzodiazepines
● chlormethiazole.
B Benzodiazepines and other drugs with effects on the central nervous system, should
be prescribed with caution.
6.46.2 Sources
A Greener et al 2001; Chollet et al 2011
B Goldstein 1998; Paolucci and de Angelis 2006
6 Recovery phase from impairments and limited activities: rehabilitation
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