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Activity Dates: 04/20/2009 - 04/20/2012

This course is closed. Please look for other available products in CPNP University.

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Session Summary

Although the prevalence of PSD depends upon whether the patients are examined in community settings or acute hospitals, the mean prevalence of major depressive disorder based on pooled data from the world’s literature is 20% during acute poststroke period for major depression and 19% for minor depression.  The diagnosis of depression is based on DSM-IV criteria for major or minor depression.  There is relatively little effect of physical illness on the manifestations of depressive symptoms.  The major risk factors for developing poststroke depression include severity of impairment in activities of daily living, in cognitive function and in social support.

In addition, previous personal history, gender, personality, and negative life events, have also been demonstrated to be associated with the development of poststroke depression.  The most controversial risk factor has been lesion location, but a meta analysis of studies examining patients within the first 2 months following stroke have demonstrated a relative risk ratio of 2.3 for patients with left anterior compared with right anterior lesions.  Poststroke depression has been demonstrated to effect recovery in activities of daily living, cognitive function and survival.  After controlling for other risk factors, patients with acute poststroke depression were 3.7 times more likely to die as early as 12 months and as long as 7 years following stroke compared to nondepressed patients.  There have been 8 double blind placebo controlled trials of antidepressants following stroke.

Nortriptyline, citalopram and reboxetine have all been shown to be significantly more effective than placebo in the treatment of poststroke depression.  In addition, escitalopram has been demonstrated in a double blind randomized treatment trial to prevent the occurrence of poststroke depression.  Patients receiving placebo were 4.5 times more likely to develop depression than patients receiving escitalopram.  Antidepressants have also been shown in both depressed and nondepressed patients to improve recovery in cognitive function, activities of daily living and decrease the probability of death.

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date. (login first)
  • Complete the evaluation at the end of the activity. (login first)
  • Receive a passing grade (60%).
  • Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor. (login first)

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

Faculty Information and Disclosures

Learning Objectives

  1. Recognize possible risk factors in post-stroke depression (PSD).
  2. Assess symptoms of PSD
  3. Assess the consequences of PSD on recovery and survival.
  4. Evaluate available controlled trials with Selective Serotonin Reuptake Inhibitors for the treatment of PSD and the effect on recovery.
  5. Identify the treatments which have been shown to be the most effective for PSD.

Continuing Education Credit and Disclosures

Activity Dates: 04/20/2009 - 04/20/2012
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-09-005-H01-P
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 1.0 contact hours (0.1 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program number assigned to this course is 0284-0000-09-005-H01-P (1.0 contact hours).

ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:

  1. Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
  2. Continuing medical education (CME) approved for CME hours
  3. Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration

Grant Support

This programming was supported in part by grants from Bristol-Myers Squibb, Forest Laboratories, Inc., Lilly, Schering-Plough, Cyberonics, and Shire.

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