Medically Reviewed by Dr. K on 17 May 2022
Table of Contents:
- Acute Stroke
- Blood Pressure Medications
- Anti-Clotting Medications
- Atrial Fibrillation Medications
- Cholesterol Medications
- Diabetes Medications
- Medications for Post-Stroke Conditions
If you've already experienced one stroke, you have a 25%-35 percent possibility of having another. Your doctor will use medication to help you reduce your chances.
They'll want to be sure the elevated blood pressure is under control. You may still choose to initiate or continue taking blood thinners, as well as drugs to treat any underlying cardiac issues.
The precise medication combination would be determined by the kind of stroke you had:
- Ischaemic strokes are caused by a clot in an artery that supplies blood to your brain.
- Haemorrhagic strokes occur as a blood vessel in the brain ruptures, causing bleeding within the brain.
- Transient ischaemic attacks (TIAs), “mini strokes”, are an indication that one may be coming. TIAs are not as long-lasting as ischaemic strokes and symptoms usually disappear on their own.
Blood Pressure Medications
Hypertension, or high blood pressure, is a leading source of all types of stroke. As a result, it's likely that you'll use medication to lower your measurements. Common treatments work in a variety of ways:
- Diuretics, also known as water pills, aid in the removal of excess salt and fluids from the body. They may be combined with other blood pressure medications. Potassium levels can be lowered by diuretics, resulting in weakness, leg cramps, and fatigue. Eating a lot of potassium-rich foods (like bananas, spinach, and sweet potatoes) may help to prevent these symptoms. If necessary, your doctor may recommend taking a potassium supplement.
- ACE inhibitors relax and expand your blood vessels. This aids in easing the blood flow.
- Beta-blockers decrease the speed and pressure of the heartbeats by blocking the effects of the hormone adrenaline. You won't take these until you've taken diuretics or other blood pressure medications before.
- Calcium channel blockers work by preventing calcium from accessing the cells of the heart and blood vessels, allowing them to relax and open up. They will even reduce blood pressure by slowing the heart rate.
- Angiotensin II receptor blockers obstruct a chemical that narrows blood vessels, making it simpler for the heart to pump.
If you've suffered an ischaemic attack, you'll almost certainly need to take medication to prevent blood clots in the future.
Surprisingly, even if you have suffered a bleeding stroke, you might be prescribed with this medication. This could be suggested by the doctor to try avoiding an ischaemic stroke or a blood clot in the lungs. Your doctor will weigh the risks of blood clots versus bleeding in your case.
- Anticoagulants are drugs that protect blood from clotting. They make clots more difficult to shape or delay their development. Warfarin and heparin are two common examples of anticoagulants. Anticoagulants are a kind of drug that is very aggressive. You normally consume them if the risk of stroke is elevated or if you have atrial fibrillation (AF), a kind of erratic irregular heartbeat.
- Antiplatelets also inhibit clot formation by preventing platelets from sticking to one another. The most widely recognized example is aspirin. If you've experienced an ischaemic stroke or a transient ischaemic attack (TIA), you may need to take aspirin or other types of antiplatelets for the remainder of your life.
Both forms of anti-clotting drugs heighten the chance of bleeding. They may also be problematic for those who have ulcers. Cauliflower, broccoli, and leafy greens should be consumed in the same amounts consistently (no more, no less) among people taking blood thinners such as warfarin (Coumadin, Jantoven), since they produce vitamin K, which may render the medication less effective. Eating the same quantity of these nutrients on a daily basis tends to maintain drug quantities in the blood stable.
Atrial Fibrillation Medications
You're 5 times more likely to get a stroke if you have this erratic heartbeat condition compared to other individuals. AF causes blood to accumulate in your heart, which can turn to clots. Anti-clotting drugs, such as aspirin or warfarin, are normally required to be taken (or stay on). However, you may need to take medication to regulate the heart rate or rhythm.
- Heart Rate Medications
These are taken to prevent the heart from pounding too quickly . One approach is with blood pressure medication, like a beta-blocker or calcium channel blocker . Digoxin (Cardoxin, Digitek, Lanoxin) is another alternative, as it reduces the speed of electrical currents as they flow through your heart.
- Heart Rhythm Medications
You may take medications to regulate your heart's rhythm (like skipped or extra beats) once you've regained a regular heartbeat (pulse). A sodium channel blocker, such as quinidine, flecainide (Tambocor), or propafenone (Rythmol), may be required to decrease the heart's capacity to conduct electricity. Sotalol (Betapace, Sorine) and amiodarone (Cordarone, Pacerone) are potassium channel blockers that function similarly by slowing the electrical signals that activate atrial fibrillation, or AF.
Following a stroke, the doctor would most probably prescribe a statin, which is a cholesterol-lowering drug. This is due to statins appearing to reduce the probability of a second stroke. You may also take them even if your LDL, or “bad" cholesterol, is only below 100 mg/dL and you have no other symptoms of narrowed blood vessels.
If you have not acknowledged that you have type 2 diabetes, you'll probably be screened for it and prediabetes after your stroke. Your doctor can prescribe medicine to regulate your blood sugar levels if they are too high. Some of them assist the body in producing more insulin. Others decrease the rate of carbohydrates break down in your bloodstream.
Medications for Post-Stroke Conditions
During your recovery from a stroke, you can develop new medical complications. That depends on the kind of attack you had, the severity of the attack, including your physical and emotional response.
- Antidepressants: After experiencing a stroke, depression and anxiety are a common repercussion . A selective serotonin reuptake inhibitor is a form of antidepressant that is often prescribed. Sertraline (Zoloft), citalopram (Celexa), paroxetine (Brisdelle, Paxil, Paxil CR, Pexeva), and fluoxetine (Prozac, Rapiflux) are some examples.
- Drugs for central pain: After a stroke, you might experience burning or aching in the body. An antidepressant known as amitriptyline, or an anti-seizure medication called lamotrigine, might be recommended by the doctor.
- Osteoporosis supplements: After a stroke, you often lose lean muscle and bone density which increases the likelihood of developing osteoporosis. Your doctor may recommend calcium and vitamin D supplements, as well as medicine, to keep your bones healthy.
Muscle spasm drugs: Following a stroke, you may encounter uncontrollable muscle movements. This is what the doctor would refer to as spasticity. An injection of botulinum toxin (Botox) can be administered to the affected muscle. They can also prescribe pain relievers to help with spasms and cramps.
Referenced on 10.4.2021
- American Heart Association: “Atrial Fibrillation Medications," “Types of Blood Pressure Medications."
- American Stroke Association: “Anti-Clotting Agents Explained," “Treatment: Recovery and Risk Reduction to Prevent a Second Stroke."
- CDC: “Types of Stroke."
- Harvard Heart Letter: “New Guidelines for the Prevention of Recurrent Stroke."
- Stroke: “Guidelines for the Prevention of Stroke in Patients With Stroke and Transient ischaemic Attack," “Guidelines for Adult Stroke Rehabilitation and Recovery, A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association."
- National Health Service: “Stroke: Treatment.”
- UpToDate: “Patient education: Hemorrhagic stroke treatment (Beyond the Basics)."
- Mayo Clinic: “High blood pressure (hypertension),” “Diabetes treatment: Medications for type 2 diabetes.”
- National Stroke Association: “Preventing Another Stroke.”