TABLE 1.

Summary of effects of pharmacotherapy in the treatment of post-stroke aphasia

Agent	Neurotransmitter	Study design	Number of studies	Main results
Bromocriptine	Dopamine	Single cases Case series Open-label RCT	11	Positive effects in open label studies mainly in transcortical motor aphasia and a dynamic aphasia of moderate severity. Improvement in overall aphasia severity in chronic patients. Variable outcomes in Broca's aphasia. Lack of efficacy in severe cases. Various RCTs negative.
Piracetam	GABA, Excitatory aminoacids	RCT	7	Positive effects in the acute stage in overall language measures, spontaneous speech and written language. Lack of efficacy in chronic stages.
Donepezil	Acetylcholine	Single cases Case series Open label RCT	6	Positive effects in global aphasia severity, communication, spontaneous speech, comprehension, naming and speed and accuracy of information processing. Efficacy maintained at long-term follow-up.
Dexanfetamine	Norepinephrine Dopamine Serotonine	Open-label RCT Single-case RCT	3	Positive effect in overall performance on communication in subacute stages with efficacy maintained at chronic stages. Negative effect in anomia in a single-subject RCT.
Bifemelane	Acetylcholine	RCT	1	Positive effect on anomia.
Fluvoxamine	Serotonine	Crossover	1	Positive effect on anomia, perseverations and mood in fluent aphasia.
Moclobemide	Serotonine Norepinephrine Dopamine	RCT	1	Negative effect.
Zolpidem	GABA	Single case	1	Positive effect, transient effect on verbal output

Notes: Only agents with a theoretically-driven rationale to be used in the treatment of aphasia were included. Other agents (e.g., haloperidol, propranolol, thiazide diuretics, chlordiazepoxide) lacking scientific justification were excluded. GABA indicates γ aminobutyric acid; RCT = randomised controlled trial. See further details and references of pharmacological studies in Berthier, 2005; Shisler et al., 2000; Small, 2004.