Post-stroke cognitive impairment
Cognitive impairment developing within 3–6 months after ischemic or hemorrhagic stroke. International guidelines have not established effective pharmacotherapy; rehabilitation relies on cognitive training and vascular risk factor control.
ICD-10 I69.32 drugs
Also known as: PSCI
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DCiticolineNot recommended · Other psychostimulants and nootropicsCiticoline is a compound promoted to help restore memory and attention after a stroke. Studies have not shown convincing benefit for post-stroke cognitive impairment, and there is no solid evidence base for this use. What actually improves thinking and speech after a stroke is early neurorehabilitation – speech therapy, cognitive training, physical therapy – along with managing blood pressure, blood sugar and other risk factors for a repeat stroke. Citicoline is harmless in this role, but don't use it in place of rehabilitation and the proven treatment your doctor prescribes, or you risk missing the care that truly helps.
- FCholine alfoscerateNot recommended · Other nervous system drugs. ParasympathomimeticsFor post-stroke cognitive impairment, choline alfoscerate lacks an evidence base by international standards. EFNS 2012 and AHA/ASA 2014 do not recommend it as a drug with confirmed efficacy. Post-stroke rehabilitation is based on cognitive training, physical rehabilitation, vascular risk factor control and depression treatment.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit