Speeding stroke recovery? A systematic review of amphetamine after stroke

Sprigg, Nikola and Bath, Philip M.W. (2009) Speeding stroke recovery? A systematic review of amphetamine after stroke. Journal of the Neurological Sciences . ISSN 0022-510X (In Press)

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Abstract

Introduction: The use of drugs to enhance recovery (“rehabilitation pharmacology”) has been assessed.

Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have

assessed its use in stroke. Methods: Electronic searches were performed to identify randomised controlled

trials of amphetamine in stroke (ischaemic or haemorrhagic). Outcomes included functional outcome

(assessed as combined death or disability/dependency), safety (death) and haemodynamic measures. Data

were analysed as dichotomous or continuous outcomes, using odds ratios (OR), weighted or standardised

mean difference, (WMD or SMD) using random-effects models with 95% confidence intervals (95% CI);

statistical heterogeneity was assessed. Results: Eleven completed trials (n=329) were identified. Treatment

with amphetamine was associated with non-significant trends to increased death (OR 2.78 (95% CI, 0.75–

10.23), n=329, 11 trials) and improved motor scores (WMD 3.28 (95% CI −0.48–7.04) n=257, 9 trials) but

had no effect on the combined outcome of death and dependency (OR 1.15 (95% CI 0.65–2.06, n=206, 5

trials). Amphetamine increased systolic blood pressure (WMD 9.3 mmHg, 95% CI 3.3–15.3, n=106, 3 trials)

and heart rate (WMD 7.6 beats per minute (bpm), 95% CI 1.8–13.4, n=106, 3 trials). Despite variations in

treatment regimes, outcomes and follow-up duration there was no evidence of significant heterogeneity or

publication bias. Conclusion: No evidence exists at present to support the use of amphetamine after stroke.

Despite a trend to improved motor function, doubts remain over

Item Type: Article
Additional Information: This version lacks figures 2-5. For full version, please see Journal of the Neurological Sciences home page: http://www.elsevier.com/wps/find/journaldescription.cws_home/506078/description#description
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Clinical Neuroscience
Depositing User: Sayers, Hazel
Date Deposited: 04 Jun 2009 11:02
Last Modified: 14 Aug 2013 13:32
URI: http://eprints.nottingham.ac.uk/id/eprint/1088

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