Limited data suggest that central nervous system depressants
such as neuroleptics, barbiturates, benzodiazepines, and anticonvulsants
are associated with poorer outcomes. Centrally
acting 2-adrenergic receptor agonists and 1-receptor antagonists
such as clonidine and prazosin have been associated with
poorer recovery in studies in animals. [Notably, benzodiazepines
have been demonstrated to cause reoccurrence of stroke
symptoms in transient ischemic attack patients.] Clinicians
should limit the use of these medications in patients recovering
from stroke as much as is practical (Evidence LevelD).
Atypical neuroleptics may be safer to use when necessary for
behavioral control in stroke patients but are only available in oral
form