News in brief: Benefits of antidepressants after stroke outweigh risks; Leading neuroscience research Institute under threat; Psychiatric symptoms strongest predictor of quality of life in epilepsy

23 Mar 2021

Benefits of antidepressants after stroke outweigh risks

The potential increase in the risk of fractures associated with the use of fluoxetine after stroke is overshadowed by its ability to prevent depression, neurologists say.

Results from the FOCUS, AFFINITY and EFFECTS trials found that six months of treatment with fluoxetine was associated with a decreased pooled risk of depression and an increased risk of fractures.

However, according to Professor Graham Hankey and colleagues from the University of Western Australia, the benefits of fluoxetine after stroke likely outweighed the risks.

When they pooled the results of the three trials they found that the absolute risk reduction of depression associated with fluoxetine use was 3.37 %, whereas the absolute risk increase of fractures was 1.76 %. The NNT to prevent one case of depression was 30 and the NNH to cause a fracture was 56. The risk benefit ratio was 0.52.

“This increased risk should be an area of concern for the practicing clinician, despite fractures being a relatively uncommon clinical complication in this population. Indeed, the 6-month probability of new depression following a stroke was 10 times greater than new fractures,” they wrote in their paper published in Maturitas.

Leading neuroscience research Institute under threat

The neuroscience research arm of the Australian National University looks set to close in response to a need to cut costs.

In a letter to staff the institution said it had come to the conclusion that its neuroscience research, while high quality, was not at a scale that enabled it to be competitive with other brain research centres.

In response to the news, the Australasian Neuroscience Society penned an open letter to the University’s Dean and Vice Chancellor in which it expressed distress at the proposed dissolution of the Eccles Institute of Neuroscience.

“This institute, the legacy of Sir John Eccles who won the Nobel prize for his research on communication between neurons, has a reputation for excellence in research and teaching in a discipline of great economic importance to Australia and the wider world” the letter notes.

“As Australia’s flagship, federally-funded university, the ANU must find a way to continue support for the vital work of the Eccles Institute of Neuroscience,” it concludes.

The letter can be signed here. 

Psychiatric symptoms strongest predictor of quality of life in epilepsy

Mental health has the biggest influence on quality of life in people with drug resistant epilepsy and psychogenic nonepileptic seizures (PNES), Australian research shows.

The cross-sectional study involving 451 patients found seizure frequency was not a significant predictor of quality of life.

Patients with PNES had significantly worse quality of life, and scored higher on measures of psychiatric symptomatology, compared to patients with epilepsy alone, the researchers from Melbourne found.

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