Section - Quick Takes

02. Fluoxetine for Stroke: A Mixed Bag of Outcomes

Published on November 1, 2021 Expired on April 1, 2025

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Fluoxetine has been considered for prophylactic use after a stroke, with some evidence that it improves functional recovery as well as prevents depression.
However, recent large trials do not support these purported benefits, and the decrease in depression is small vs a small risk of very concerning side effects: Falls, fractures, and seizures.
Author Dr. Chittaranjan Andrade demonstrates his prowess at synthesizing the literature, including not being lead astray by a tempting meta-analysis.

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Text version

Imagine a beautiful landscape oil painting, the way it becomes almost abstract when you stand up close and then turns back into a tranquil scene as you take a few steps back. You can imagine the artist carefully selecting each color, adding a dab here, smudging or mixing a dab there. You’re watching a master, a creator.

Hi! Jim Phelps here for the Psychopharmacology Institute. In this Quick Take, we’ll watch another master at work, one of our psychiatry colleagues who can create a big picture, a broad landscape with a careful analysis of a few studies that when viewed close up might seem mystifying and almost meaningless. I hope you’ve seen his work before—Dr. Chittaranjan Andrade. His recent examination of fluoxetine for stroke is of interest for clinical practice. Do antidepressants improve a patient’s course after stroke? Now, it’s also of interest simply to watch how Dr. Andrade synthesizes

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03. α2-Adrenergic Agonists or Stimulants for Preschool-Age Children With Attention-Deficit/Hyperactivity Disorder

Learning Objectives:

After completing this activity, the learner will be able to:

Examine the sensitivity and specificity of multiple symptoms and labs used in the diagnosis of myocarditis among patients taking clozapine.
Evaluate the evidence for the use of prophylactic fluoxetine after a stroke for improving neurologic outcomes and recovery rates as well as preventing depression.
Assess the relative efficacy and adverse event potential of methylphenidate vs alpha-adrenergic agonists in preschool children with ADHD.
Review recent research regarding the effect of antidepressant initiation on suicidal ideation.
Examine recent research regarding prognostic factors for recurrence for patients with first-episode psychosis.

Original Release Date: November 1, 2021

Review and Re-release Date: March 1, 2024

Expiration Date: April 1, 2025

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.