Coronary disease & ACSMeta-analysis
Depression following stroke and myocardial infarction: effective strategies and evidence gaps. A systematic review
- Systematic review of randomised trials
PubMed searched 17th April 2025; Randomised controlled trials (RCTs) ≥4 weeks' intervention published since 1st January 2000; Cochrane Risk of Bias tool
Authors' conclusion
A holistic, multidisciplinary, and tailored approach encompassing pharmacological treatments together with non-pharmacological interventions (psychological therapy, device-based stimulation, and physical activity/exercise) is beneficial in reducing depression severity or risk amongst those with recent stroke, but there is a lack evidence for the long-term efficacy amongst those with recent MI.
Study context
- Population
- Patients with recent non-fatal stroke or myocardial infarction (MI) (44 post-stroke, 9 post-MI studies)
- Participants
- 53 RCTs
- Comparison
- Pharmacological and non-pharmacological interventions vs routine care/no active treatment
- Pharmacologicaln = 16
- Non-pharmacologicaln = 37
- Outcome
- Depressive symptoms measured with validated tools
Pooled result
As reported in the abstract
Depression severity
- Some SSRIs (escitalopram) and SNRIs (duloxetine, milnacipran) effective in reducing depression severity in stroke survivors
- Psychological interventions, device-based stimulation (vagus nerve, transcranial) and some physical activity/exercise interventions appear efficacious after recent stroke
- Substantial evidence gap for efficacy of these interventions in MI survivors
Original publication
Depression following stroke and myocardial infarction: effective strategies and evidence gaps. A systematic review. Eur J Prev Cardiol. Published 10 March 2026. doi:10.1093/eurjpc/zwag144
Summarised from the published abstract; every number is checked against it