Cilostazol may be a better therapeutic agent for acute ischemic stroke because of its efficacy in preventing post-stroke depression

Post-stroke depression (PSD) has more than 1/3 complications in ischemic stroke (IS) patients, but there is still no specific drug that can effectively prevent the occurrence of PSD. Cilostazol, commonly used in the treatment of IS, has been found to rescue cognition impairment in recent years, but whether it has the efficacy in preventing PSD remains uncertain. In this study, a total of 431 acute ischemic stroke (AIS) patients treated with and without cilostazol during 2021-2022 were recruited and followed up for 6 months. At the end of follow-up, we found that AIS patients of cilostazol-treated group had significantly lower National Institutes of Health Stroke Scale (NIHSS) and 24-item Hamiltons Depression Scale (HAMDS) scores than patients of cilostazol-free group (p<0.05), the total incidence of depression was 15.47% in patients of cilostazol-treated group and 36.02% in patients of cilostazol-free group, including 8.84% and 16.67% mild depression (p<0.05), 6.08% and 12.90% moderate depression (p<0.05), 0.55% and 6.45% major depression (p<0.01), respectively. In addition, the plasma levels of high-sensitive C-reactive protein (Hs-CRP), homocysteine (HCY), tumor necrosis factor- (TNF-), interleukin-1{beta} (IL-1{beta}) and neutrophil/lymphocyte ratio (NLR) in AIS patients of cilostazol-treated group were all lower than those in patients of cilostazol-free group (p<0.05). These results suggest that cilostazol is a better therapeutic agent for AIS because it may prevent PSD by decreasing the levels of inflammation in patients.