Post-stroke depression not reduced by 2,000 IU of vitamin D (not a surprise)
The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients
Medicine: November 12, 2021 - Volume 100 - Issue 45 - p e27747 doi: 10.1097/MD.0000000000027747
Torrisi, Michele Psy D; Bonanno, Lilla MSc, PhD∗; Formica, Caterina Psy D; Arcadi, Francesca Antonia MD; Cardile, Davide Psy D; Cimino, Vincenzo MD; Bramanti, Placido MD; Morini, Elisabetta MD
Post-Stroke depression affects between 12% and 72% of patients who have suffered a stroke. The association between low serum levels of 25-hydroxyvitamin D (25(OH) D) and increased risk of depression is reported in both stroke and non-stroke patients. Similarly, high 25(OH) D levels might be associated with greater functional improvement during rehabilitation program.
We wanted to investigate the effects of an intensive rehabilitation on poststroke outcomes. We wondered if the daily rehabilitation of motor and cognitive functions could also have an effect on mood and functional abilities in addition to or as an alternative to vitamin D supplementation.
We conducted a 12-week, randomized trial, double blind, parallel, monocentric clinical trial of 40 patients undergoing intensive neuro-rehabilitation treatment at a specialized care facility for ischemic or hemorrhagic brain stroke. Participants were randomly assigned, in a 1:1 ratio, to 1 of 2 parallel groups: in the experimental group, 2000 IU/day of oral cholecalciferol was administered; in the control group patients were not taking vitamin D supplementation. Patients underwent a text evaluation to investigate psychological and motor outcomes.
Significant intra-group difference in outcomes measures was found but not between control group and experimental group. In the vitamin D group, we highlighted significant differences between T0 and T1 in calcium (P < .001), vitamin D (P < .001), in Montgomery Aasberg Depression Rating Scale (P = .001), and in Functional Independent Measures (P < .001). In the health control group, we found a significant difference in calcium (P = .003), vitamin D (P < .001), Montgomery Aasberg Depression Rating Scale (P = 0.006), in general self-efficacy (P = .009), and in Functional Independent Measures (P < .001).
Our results show that the beneficial effect on mood and functional recovery is mainly due to neurorehabilitation rather than vitamin D supplementation.
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Probably far less depression if had started with a loading dose
Overview Loading of vitamin D Without starting with a loading dose,
daily dosing often takes >3 months to provide any benefit
A few relevant stroke studies
Stroke patients getting weekly 50,000 IU Vitamin D did better – trial March 2021
Stroke patients need more than 2,000 IU of vitamin D (found this time in Japan) – RCT June 2019
Stroke rehabilitation (and prevention) requires Vitamin D actually getting to cells – March 2020
Improved recovery from ischemic stroke with Vitamin D (300,000 IU injection) – RCT June 2018
Vitamin D levels drop after ischemic stroke – Dec 2017
- Stroke patients need even more vitamin D than the typical patient
Ischemic Stroke risk reduced by 2.5 if have good level of vitamin D – meta-analysis Feb 2018
- Having high vitamin D greatly reduces both getting a stroke and the subsequent depression
Stroke and Depression
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Intervention of Vitamin D for Depression
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Meta-analyses of Vitamin D and Depression
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Depression is reduced by Vitamin D, Omega-3, Magnesium, etc.
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