Medicines for Stroke Prevention

After a stroke and during rehabilitation, you need medicines to help prevent another stroke. You may need medicines to thin your blood and prevent clots from forming and medicines to lower blood pressure and cholesterol.

Medicines you may take after a stroke include:

• Antiplatelets to prevent blood clots.
• Anticoagulant medicine.
• Statins to lower cholesterol.
• Angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure.
• Angiotensin II receptor blockers (ARBs) to lower blood pressure.
• Beta-blockers to lower blood pressure.
• Diuretics to lower blood pressure.

Medicines for Stroke Rehabilitation

After a stroke, you may need medicines to decrease pain, treat depression, or help speed your recovery. These may include:

• Medicines for pain and depression after a stroke. Examples are:
  • Selective serotonin reuptake inhibitors (SSRIs) for pain and depression.
  • Tricyclic antidepressants for pain and depression.
  • Anticonvulsant medicines for pain.
• Medicines for sleeping. After a stroke, you may have trouble sleeping (insomnia). Your doctor may prescribe different types of medicines to help you sleep, including the antidepressants trazodone (Desyrel, for example) and mirtazapine (Remeron), which have sedation as a side effect. Other sleep medicines, such as chloral hydrate, may be effective but have the potential for addiction.
• Medicines for anxiety. Various medicines may be used to treat anxiety after a stroke. Benzodiazepines, such as lorazepam (Ativan, for example), are minor tranquilizers or sedatives that slow down the central nervous system. Alprazolam (Xanax) and buspirone (BuSpar) are antianxiety medicines that relieve anxiety and nervousness.
• Medicines for agitation. Doctors use various types of medicines to treat agitation. Neuroleptics, such as haloperidol (Haldol), risperidone (Risperdal), and olanzapine (Zyprexa, for example), are antipsychotic medicines that work by changing the effects of brain chemicals. The anticonvulsant valproic acid (Depakote, for example) is sometimes used to treat agitation.
• Methylphenidate (Ritalin, for example) to improve mood and speed recovery. This medicine is sometimes used for a short time in the first stages of rehab.
• Dextroamphetamine (Dexedrine, for example) to improve attention span and help learning and memory. Experts are still researching the benefits and risks of this drug for people who have had a stroke.

Also see Treatment for Stroke-Related Spasticity.