Pharmacotherapy for Aphasia

There are no currently approved drug therapies to assist in the recovery from aphasia. However, there is suggestive evidence from the animal literature that behavioral training, coupled with pharmacotherapy, can enhance recovery from motor stroke. Most of the pharmacologic interventions used in these studies involved sympathomimetic drugs, although other mechanisms were used as well, such enhancement in cholinergic signaling. A number of studies have been performed using human patients with aphasia. These studies are also suggestive of enhancement in recovery when sympathomimetic drugs are used in conjunction with speech and language therapy. There are also data to support cholinesterase inhibitors memantine and piracetam. In addition, other drugs, such as barbiturates, antipsychotics, and anticonvulsants, may slow recovery. Although more work is needed, these studies, which are critically reviewed herein, suggest that thoughtful use of pharmacologic agents in conjunction with speech and language therapy can enhance recovery from aphasic stroke.