Speeding stroke recovery? A systematic review of amphetamine after stroke

Introduction: The use of drugs to enhance recovery (“rehabilitation pharmacology”) has been assessed. Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have assessed its use in stroke. Methods: Electronic searches were performed to identify randomi...

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Main Authors: Sprigg, Nikola, Bath, Philip M.W.
Format: Article
Published: Elsevier 2009
Online Access:https://eprints.nottingham.ac.uk/1088/
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author Sprigg, Nikola
Bath, Philip M.W.
author_facet Sprigg, Nikola
Bath, Philip M.W.
author_sort Sprigg, Nikola
building Nottingham Research Data Repository
collection Online Access
description Introduction: The use of drugs to enhance recovery (“rehabilitation pharmacology”) has been assessed. Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have assessed its use in stroke. Methods: Electronic searches were performed to identify randomised controlled trials of amphetamine in stroke (ischaemic or haemorrhagic). Outcomes included functional outcome (assessed as combined death or disability/dependency), safety (death) and haemodynamic measures. Data were analysed as dichotomous or continuous outcomes, using odds ratios (OR), weighted or standardised mean difference, (WMD or SMD) using random-effects models with 95% confidence intervals (95% CI); statistical heterogeneity was assessed. Results: Eleven completed trials (n=329) were identified. Treatment with amphetamine was associated with non-significant trends to increased death (OR 2.78 (95% CI, 0.75– 10.23), n=329, 11 trials) and improved motor scores (WMD 3.28 (95% CI −0.48–7.04) n=257, 9 trials) but had no effect on the combined outcome of death and dependency (OR 1.15 (95% CI 0.65–2.06, n=206, 5 trials). Amphetamine increased systolic blood pressure (WMD 9.3 mmHg, 95% CI 3.3–15.3, n=106, 3 trials) and heart rate (WMD 7.6 beats per minute (bpm), 95% CI 1.8–13.4, n=106, 3 trials). Despite variations in treatment regimes, outcomes and follow-up duration there was no evidence of significant heterogeneity or publication bias. Conclusion: No evidence exists at present to support the use of amphetamine after stroke. Despite a trend to improved motor function, doubts remain over
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spelling nottingham-10882020-05-04T20:27:04Z https://eprints.nottingham.ac.uk/1088/ Speeding stroke recovery? A systematic review of amphetamine after stroke Sprigg, Nikola Bath, Philip M.W. Introduction: The use of drugs to enhance recovery (“rehabilitation pharmacology”) has been assessed. Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have assessed its use in stroke. Methods: Electronic searches were performed to identify randomised controlled trials of amphetamine in stroke (ischaemic or haemorrhagic). Outcomes included functional outcome (assessed as combined death or disability/dependency), safety (death) and haemodynamic measures. Data were analysed as dichotomous or continuous outcomes, using odds ratios (OR), weighted or standardised mean difference, (WMD or SMD) using random-effects models with 95% confidence intervals (95% CI); statistical heterogeneity was assessed. Results: Eleven completed trials (n=329) were identified. Treatment with amphetamine was associated with non-significant trends to increased death (OR 2.78 (95% CI, 0.75– 10.23), n=329, 11 trials) and improved motor scores (WMD 3.28 (95% CI −0.48–7.04) n=257, 9 trials) but had no effect on the combined outcome of death and dependency (OR 1.15 (95% CI 0.65–2.06, n=206, 5 trials). Amphetamine increased systolic blood pressure (WMD 9.3 mmHg, 95% CI 3.3–15.3, n=106, 3 trials) and heart rate (WMD 7.6 beats per minute (bpm), 95% CI 1.8–13.4, n=106, 3 trials). Despite variations in treatment regimes, outcomes and follow-up duration there was no evidence of significant heterogeneity or publication bias. Conclusion: No evidence exists at present to support the use of amphetamine after stroke. Despite a trend to improved motor function, doubts remain over Elsevier 2009 Article PeerReviewed Sprigg, Nikola and Bath, Philip M.W. (2009) Speeding stroke recovery? A systematic review of amphetamine after stroke. Journal of the Neurological Sciences . ISSN 0022-510X (In Press) http://www.elsevier.com/wps/find/journaldescription.cws_home/506078/description#description doi:10.1016/j.jns.2009.04.040 doi:10.1016/j.jns.2009.04.040
spellingShingle Sprigg, Nikola
Bath, Philip M.W.
Speeding stroke recovery? A systematic review of amphetamine after stroke
title Speeding stroke recovery? A systematic review of amphetamine after stroke
title_full Speeding stroke recovery? A systematic review of amphetamine after stroke
title_fullStr Speeding stroke recovery? A systematic review of amphetamine after stroke
title_full_unstemmed Speeding stroke recovery? A systematic review of amphetamine after stroke
title_short Speeding stroke recovery? A systematic review of amphetamine after stroke
title_sort speeding stroke recovery? a systematic review of amphetamine after stroke
url https://eprints.nottingham.ac.uk/1088/
https://eprints.nottingham.ac.uk/1088/
https://eprints.nottingham.ac.uk/1088/