What Medications Do People Take After a Stroke?

Medication Used for Recovery and Prevention

A stroke is the result of a disruption in blood flow to the brain, either due to a blockage or bleeding. The blood vessels that supply the brain are extremely narrow and fragile. As a result, the vessels are at risk of damage and breaking from small clots or elevated blood pressure.

Ultimately, if blood flow to the brain is disrupted for a long period of time, then damage known as ischemia will occur within the brain. Brain tissue is not able to regenerate, so damage in the brain is permanent. The consequences of a stroke can be severe. 

Fortunately, medications are available to reduce the risk of cerebrovascular events such as stroke and prevent the development of future strokes. Studies suggest that the risk of a future stroke is around 12% after the first stroke. As a result, most medical treatments are focused on reducing the risk of stroke recurrence.

Medications after stroke

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There is a form of stroke that occurs when someone begins to experience the symptoms of a stroke, but then the symptoms quickly resolve and go away. This is known as a ministroke or transient ischemic attack (TIA).

While a ministroke may not lead to lasting damage, it is still a serious event. A ministroke is a risk factor for future strokes. It should be followed by prompt medical evaluation and treatment to prevent more permanent damage.

This article will discuss medications used to manage conditions that may lead to stroke, as well as the drugs used to treat conditions that develop after a stroke.

Anticlotting Drugs and Blood Thinners

Clot formation and the breakup of clots depend on platelets (blood cells that are active in clotting) and various proteins in the blood. Medications address different aspects of the clotting process.

Antiplatelet Drugs

One of the first drugs used to treat a stroke is an antiplatelet agent. These drugs stop the formation of clots within blood vessels and reduce the size of a clot during a stroke. The commonly used antiplatelet drugs are:

Anticoagulants

Anticoagulants (commonly called blood thinners) work to reduce the formation of blood clots. These medications have a similar purpose as antiplatelet agents, but they work using a different mechanism. They are used to treat specific forms of stroke, such as a stroke caused by atrial fibrillation (a disordered heart rhythm).

The most commonly used anticoagulants are:

Blood Pressure Drugs

Medications to lower blood pressure are shown to decrease the risk of cardiovascular disease and stroke. Elevated blood pressure can cause damage to the small blood vessels found in the brain.

Severely uncontrolled blood pressure can lead to transient ischemic attacks, hemorrhagic brain bleeds, and ischemic strokes (caused by blockages in the blood vessels).

There are several different classes of blood pressure medications. The most commonly used medications in each class to control blood pressure are:

Angiotensin Converting Enzyme (ACE) Inhibitors

ACE inhibitors work against angiotensin II, a hormone that constricts blood vessels and raises blood pressure. These drugs include:

Angiotensin Receptor Blockers (ARBs)

ARBs also act against angiotensin II and thereby reduce blood pressure. They include:

Calcium Channel Blockers

Calcium channel blockers relax blood vessels by reducing the amount of calcium that flows into them, which reduces blood pressure. These drugs include:

Beta-Blockers

Beta-blockers reduce blood pressure by blocking the effect of adrenaline (epinephrine) on the heart and other tissues. They include:

  • Lopressor and Toprol (metoprolol)
  • Tenormin (atenolol)

Cholesterol Drugs: Statins

Statin medications help reduce the a person's cholesterol levels (amount of a fatty, waxy substance in the blood) and reduce the risk of future ischemic strokes. Statin medications that are commonly used are:

Tissue Plasminogen Activator (tPA)

Tissue plasminogen activator (tPA), also known as alteplase, is used to treat acute ischemic stroke to break down clots within arteries that supply the brain. It helps by restoring blood flow to regions of the brain that were blocked.

Tissue plasminogen activators are very powerful agents that are only used in specific circumstances. Importantly, there is a time window from the onset of the stroke in which tPA is most effective. This generally is within 4.5 hours of the onset of symptoms. Outside of this specific time window, tPA may be more harmful than beneficial.

Atrial Fibrillation Drugs

Atrial fibrillation (AFib) is an irregular heart rhythm that is often rapid. It's a known risk factor for stroke because the irregular rhythm can lead to the formation of blood clots. Several medications are used to treat atrial fibrillation, including medications that slow your heart rate and correct your heart rhythm.

Some medications that control and manage atrial fibrillation include:

  • Cartia (diltiazem)
  • Cordarone (amiodarone)
  • Sotylize (sotalol)
  • Toprol (metoprolol)
  • Verelan (verapami)

Diabetes Drugs

Diabetes (a chronic condition affecting how your body uses blood sugar) is a well-established risk factor for the development of stroke. Diabetes causes blood vessels to undergo extra wear and tear over time, leading to premature aging and damage.

For these reasons, controlling diabetes through appropriate blood sugar control is a critical form of stroke prevention and management.

A few of the medications used for diabetes are :

  • Actos (pioglitazone)
  • Glucophage (metformin)
  • Glynase (glyburide)
  • Insulin (synthetic form of the hormone made by the pancreas to regulate blood sugar)
  • Januvia (sitagliptin)
  • Jardiance (empagliflozin)

Medications After a Stroke

Any of the previously mentioned medications can be used after a stroke to help reduce the risk of a future stroke. There also are a few medications that may be required after a stroke to help with conditions resulting from the stroke. These include drugs to improve mood. The brain changes after a stroke and depression is a common problem after suffering a stroke.

Depression medications include:

If you have seizures (episodes of erratic brain electrical activity) after a stroke, you may also be prescribed anti-seizure medications. These include:

  • Keppra (levetiracetam)
  • Depakote (valproic acid)

Summary

A stroke is a serious event that is strongly linked to cardiovascular disease. Treatment after a stroke is focused on reducing the severity of stroke as quickly as possible in combination with reducing your risk of future strokes. Many medications that focus on different areas of health that may help reduce your future risk of stroke and cardiovascular disease.

A Word From Verywell

A stroke can be a frightening and life-changing event. It is completely normal to feel as if you’ve lost some control of your life after experiencing a stroke. Fortunately, many medications are available to help combat risk factors and symptoms after a stroke

Frequently Asked Questions

  • What is a common medication used after a stroke?

    One of the most common medications used after a stroke is aspirin. Aspirin has been shown to reduce the risk of a repeat stroke.

    If you have previously taken aspirin and experienced side effects such as severe bleeding, your doctor may recommend a different medication. However, it remains one of the most commonly prescribed medications after a stroke since it is widely available.

  • What medication is prescribed after a ministroke (TIA)?

    After experiencing a ministroke, your healthcare provider may request that you take medications to reduce your risk of a repeat event, or the development of a more severe stroke.

    These medications will depend on your other medical conditions and can include blood pressure medications, cholesterol medications, atrial fibrillation medications, diabetes medications, or a combination of these.

  • What drug can be used to treat a stroke?

    A stroke can be treated, and in some instances reversed, with the use of the medication tissue plasminogen activator (tPA). Due to the potent capabilities of tPA, it is only used in specific circumstances and within a specific time interval.

    The use of tPA is not always necessary, or appropriate, for all forms of stroke. 

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