Stroke buster drugs called tissue plasminogen activators, were first approved by the FDA as far back as 1996. Long term studies on the use and effects of these drugs have shown that while the stroke busting drugs improve the quality of life, they don’t have a marked effect on survival rates. When a stroke is caused by a thrombolytic clot instead of a hemorrhagic one, the clot busting drugs, chief among them being Alteplase, can stop the effects of the clot by busting it.

Who can take Alteplase?

So a patient, who experiences the first signs of a stroke, like speech slurring, heaviness or paralysis, inability to smile or sometimes talk, drooping face/eyelids, muscle weakness and is taken to a medical center and given the medicine, may suffer minimal brain damage and recover very fast. In fact the sooner the drug is given, the more effective it is.

However, the drug can only be given after proper assessment and checking to see that it is not a hemorrhagic clot that has caused the stroke. The patient should be in a fit condition to take the drug, which is given intravenously and should not have any other medical problem that would contraindicate the use of this drug.

Important research study

A randomized controlled trial by the University of Edinburgh and published in The Lancet Neurology recently conducted on 3035 patients from different countries showed that patients who were given this stroke busting medicine and also received standard care, when compared to patients who did not receive the medicine but only got standard care fared much better. Their quality of life improved and they did not suffer the many negative effects of stroke, including disability and dependency.

The study found out that 34.9 percent of the patients in the group that received the drug died while 35.1 percent of the patients in the group that did not receive the drug also died – not a very significant difference in survival rates. But patients who received the drug had a better quality of life as they were able to resume normal activities soon after, while the patients who only received managed care suffered from a varying degree of disability.

Can all stroke patients benefit from this drug?

It is not like all patients can benefit from stroke busting drugs. A patient who suffers a stroke needs a complete medical assessment before being administered the drug. There is a 3 percent risk of bleeding in the brain that can be fatal, so the risk-benefit ratio has to be explained to the patient before administering the medicine. A patient who has had a minor stroke may not want to take this medicine, preferring to undergo physical and other therapies. A patient who is greater risk of suffering permanent physical damage or being bed-ridden may accept the risk factors involved rather that completely compromising on the quality of life.

Another factor is that this drug needs to be administered as quickly as possible and there is a 1-4.5 hour window, before the brain is permanently damaged. As things stand a patient is more likely to receive this drug at a specialized stroke center than a general hospital setting.

If you are increased risk of stroke due to high blood pressure and atherosclerosis, or other risk factors, you should put your research in place not only regarding the symptoms of a stroke, but also the treatment options, because there is no time to waste once the stroke has occurred.

New treatment options that beat the time barrier to a certain extent may be available by 2015. Researchers at Glasgow are working on a new treatment that may possibly be usable up to 48 hours after a stroke. This consists of identifying the penumbra in the brain via MRI scans, oxygen-carrying perflourocarbon (PFC) and oxygen to find out where exactly the penumbra-viable dead tissue in the brain is and then delivering oxygen with PFC targeting that area. This is being touted as the Holy Grail of stroke treatment.

Till it goes to human trials and then, depending on the outcome, goes into use, conventional and approved medical therapy is the only way to treat stroke patients. Stroke patients often take a long time to recover as they have to take medicines and undergo physical therapy to recover many functions and using a drug like Alteplase can certainly help improve the quality of life and even reduce long term treatment costs.


The Lancet Journal