Increased lower limb spasticity but not strength or function following a single-dose serotonin reuptake inhibitor in chronic stroke

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Study investigated the effects of single doses of a selective serotonin reuptake inhibitor (SSRI) on lower-limb voluntary and reflex function in individuals with chronic stroke. Ten individuals with post-stroke hemiplegia for more than 1 year were assessed before and 5 hours after they were randomly assigned to receive a single 10-milligram dose of escitalopram (SSRI) or placebo. Primary assessments included maximal ankle and knee isometric strength, and velocity-dependent plantarflexor stretch reflexes under passive conditions, and separately during and after 3 superimposed maximal volitional drive to simulate conditions of increased serotonin release. Secondary measures included clinical measures of lower limb coordination and locomotion. The results indicated that SSRI administration significantly increased stretch reflex torques at higher stretch velocities, with reflexes at lower velocities enhanced by superimposed voluntary drive. No significant improvements were seen in strength or in clinical measures of lower-limb function after the single-dose SSRI administration. Further studies should evaluate whether repeated dosing of SSRIs, or as combined with specific interventions, is required to elicit significant benefit of these agents on post-stroke lower-limb function

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