While undergoing rehabilitation, stroke patients frequently receive
a variety of medications to treat complications of stroke or
other unrelated chronic medical conditions. We do not recommend
amphetamine use for motor recovery, on the basis of
negative large amphetamine clinical stroke recovery trials
and the lack of documented long-term benefits. Limited data
support the use of other neurotransmitter-releasing agents to
promote stroke recovery, including methylphenidate,levodopa,and L-threo-3,4-dihydroxyphenyl serine (L-DOPS).
Fluoxetine in nondepressed patients appeared to have a small
benefit in motor recovery independent of the treatment of
depression. Modafinil, a novel stimulant, is selectively used in
stroke patients but without proven safety or efficacy. Current
data do not permit discrimination among these agents, identification
of optimal dosing, or selection of the preferred time of
initiation of pharmacotherapy after stroke or the duration of
treatment