Enhancing recovery after stroke with noradrenergic pharmacotherapy: A new frontier?

Despite much progress in stroke prevention and acute intervention, recovery and rehabilitation have traditionally received relatively little scientifi c attention. There is now increasing interest in the development of stroke recovery drugs and innovative rehabilitation techniques to promote function al recovery after completed stroke. Experimental work over the past two dec ades indicates that pharmacologic intervention to enhance recovery may be p ossible in the subacute stage, days to weeks poststroke, after irreversible injury has occurred, This paper discusses the concept of "rehabilitation p harmacology" and reviews the growing literature from animal studies and pil ot clinical trials on noradrenergic pharmacotherapy, a new experimental str ategy in stroke rehabilitation, Amphetamine, a monoamine agonist that incre ases brain norepinephrine levels, is the most extensively studied drug show n to promote recovery of function in animal models of focal brain injury. F urther research is needed to investigate the mechanisms and clinical effica cy of amphetamine and other novel therapeutic interventions on the recovery process.