Failure of central nervous system serotonin blockage to influence outcome in acute cerebral infarction. A double blind randomized trial.

To determine the effect of blocking central nervous system (CNS) serotonin reuptake in the outcome of acute cerebral infarction (ACI), 49 patients were studied in a double blind, randomized trial. All patients suffered hemispheric ACI, were seen within 24 hours of onset, and were treated with low dose, subcutaneous heparin to prevent venous thrombosis; 25 received 10 mg. of trazodone hydrochloride intravenously every 12 hours for seven days and 24 were given an identically appearing placebo. To monitor trazodone effect, indol derivatives were measured in spinal fluid collected before and after treatment in 38 patients. Treatment and placebo patients had similar demographic characteristics, comparable risk factors, and neurologic deficit at onset. No appreciable difference was seen between treatment and control patients in regard to intercurrent events, degree of neurologic deficit, time of hospitalization, and mortality. Indol derivatives were consistently higher in the spinal fluid of trazodone patients after treatment, confirming serotonin reuptake blockage; however, this seems to have had no beneficial effect on the outcome of ACI.