This is not the most recent version of the article. View current version (24 JAN 2007)
Amphetamines for improving recovery after stroke
Editorial Group: Cochrane Stroke Group
Published Online: 21 JUL 2003
Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Martinsson L, Wahlgren NG, Hårdemark HG. Amphetamines for improving recovery after stroke. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD002090. DOI: 10.1002/14651858.CD002090.
- Published Online: 21 JUL 2003
This is not the most recent version of the article. View current version (24 Jan 2007)\
Experimental animal research shows that treatment with amphetamines improves recovery after focal cerebral ischaemia. If the effect were similar in humans, amphetamine treatment could have a major impact on recovery from stroke.
The objective of this review was to assess the effects of amphetamine treatment in patients with stroke.
We searched the Cochrane Stroke Group Trials Register (last searched November 2002). In addition, we searched the Cochrane Controlled Trials Register (Cochrane Library, Issue 4 2002), MEDLINE (1966-September 2002), EMBASE (1980-November 2002), and Science Citation Index (1992-December 2002). The reference lists of all relevant articles and reviews were checked, and we contacted researchers in the field to identify further published and unpublished studies.
Randomized unconfounded trials comparing amphetamine with placebo.
Data collection and analysis
Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.
Seven studies involving 172 patients were included. The quality of the trials varied but was generally high. Based on two trials (85 patients) there was no evidence that amphetamine treatment reduced death or dependence (Peto's odds ratio, [Peto OR] 1.54; 95% Confidence Interval [CI] 0.64 to 3.73). In these two trials, there were imbalances at baseline, with more serious strokes allocated to amphetamine. This imbalance may account for the trend for more deaths at the end of follow-up among amphetamine allocated patients (Peto OR 3.33; 95% CI 0.99 to 11.24). Based on 4 studies (95 patients) there was evidence of a better relative change in motor function according to the Fugl-Meyer motor scale (Weighted Mean Difference, [WMD] -8.17 points; 95% CI -13.58 to -2.76) and based on 1 study (21 patients) there was evidence of a better change in language function as assessed by the Porch Index of Communicative Ability score (WMD -7.51 points; 95% CI -14.42 to -0.60) in amphetamine allocated patients.
At present, too few patients have been studied to draw any definite conclusions about the effects of amphetamine treatment on recovery from stroke. The suggested benefits on motor and language function, and the non-significant trend towards increased risk of death, could be related to imbalances in prognostic variables or other bias in studies. Further research in this area is therefore justified.
Plain language summary
No clear evidence that amphetamines improve recovery after stroke.
Amphetamines are stimulants. Experiments in animals have suggested that amphetamines might be able to improve recovery from stroke in humans. This review identified a few, small randomized trials of amphetamines in patients with stroke. There was no evidence that amphetamines did more good than harm. There is not enough evidence to support the routine use of amphetamines to promote recovery after stroke. Further controlled trials are needed.