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Clinical depression, either major or minor, affects about 40% of patients after a stroke and contributes to substantial poststroke disability. Previous studies of the benefits of antidepressants after stroke in preventing depression have shown mixed results.
This multisite study of interventions to prevent poststroke depression involved 176 patients (mean age, 64) who had experienced a stroke (mostly supratentorial ischemic stroke) within 3 months of enrollment; patients with depression or other major chronic or disabling diseases at baseline were excluded. Patients were randomized to escitalopram (5–10 mg per day, blinded), problem-solving therapy (unblinded), or placebo and underwent structured diagnostic interviews every 3 months for 1 ye…