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Recover Faster from a Stroke

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You already know that the most important thing you can do if you are having a stroke (or suspect that you are) is to get to an emergency room as fast as possible. Every second that you save may stop precious brain tissue from dying.

But what you and your care team do in the days immediately after a stroke also is critical—especially for recovering from motor deficit and regaining control of your muscles.

Two important new findings…

First finding: In animal studies in a lab, waiting just one week to start rehab led to significantly worse outcomes.

Second finding: A certain medication can prevent that stroke recovery window from closing so quickly.

The overall window for stroke recovery in people continues well past the first week, of course. Many people who have had strokes can continue to improve for months, even years. So never give up! But here’s what to do immediately after the emergency phase…

Start rehab quickly. Take advantage of that early recovery period—the sooner you begin, the greater your recovery. If your doctors don’t start your rehab in the hospital a day or two after the stroke, ask about it and push for it—even if there are medical issues that make it difficult.

Ask about the drug fluoxetine. Other recent research has shown that this ­antidepressant, aka Prozac, started within one day after a stroke, not only improves recovery but also extends the length of the recovery window. An earlier randomized clinical trial showed that patients with moderate-to-severe motor deficit after ischemic stroke (the most common kind, caused by a blood clot) who took fluoxetine every day for three months, starting five to 10 days after a stroke, had significantly greater improvement than patients who received a placebo. Other drugs in the same class also seem to improve stroke recovery, but the most data exist for fluoxetine—and the new research adds to the urgency of that prescription. While more and more physicians are prescribing fluoxetine, it is not yet a standard of care—so ask.

Engage your brain right away. What you do matters, too—so don’t rely solely on rehab services. Do your best to stimulate your brain by playing games on a tablet or working on a puzzle. When people visit you in the hospital, rather than just watching TV together or exchanging pleasantries, have a real conversation about current events or a book you recently have read. In animal studies, mice kept in enriched and stimulating environments after stroke had greater recovery than those kept in simple cages. You want as much of your brain back as possible…so use it as soon as possible!

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Source: Steven R. Zeiler, MD, PhD, head of stroke research at Johns Hopkins Bayview Medical Center in ­Baltimore Date: February 15, 2018
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