Transient Ischemic Attack (TIA, Mini-Stroke) - Treatment

What kinds of treatment or medication did you receive for a TIA?

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What is the treatment for a transient ischemic attack (TIA)?

TIA Therapy

Treatment for a transient ischemic attack is aimed at preventing a second stroke. Since there is no way of determining the severity of future episodes, and no guarantee that the symptoms will resolve, prevention of a future TIA or CVA is crucial.

Treatment guidelines address a variety of targeted goals.

Antiplatelet therapy

  • If the patient was not taking aspirin when the TIA occurred, it usually is started at a dose of 325mg per day.
  • If the patient was taking aspirin, another antiplatelet drug called dipyridamole may be added. Aggrenox is a combination of aspirin and dipyridamole. Headache is often a side effect.
  • If the patient cannot tolerate aspirin because of allergy or stomach upset clopidogrel (Plavix) may be used.

High blood pressure therapy

  • Even if the patient does not have hypertension or high blood pressure, there may be benefit in taking anti-hypertensive medications.
  • Two classes of drugs are recommended to be started at the same time, a diuretic and an ACE inhibitor.
  • The goal for normal blood pressure is 120/80.

Cholesterol lowering therapy

  • Guidelines recommend that a statin drug be started, even if cholesterol levels are normal. Simvastatin (Zocor) is the most commonly recommended medication, but new guidelines limit the amount prescribed per day because of the risk of liver side effects.

Risk modification

Smoking, excessive alcohol, obesity and lack of physical activity are considered risks for future stroke. The following recommendations are now suggested:

  • Smoking: Counseling, smoking cessation aids like nicotine gum or medications like varenicline (Chantix) should be considered. Environmental smoke should be avoided.
  • Alcohol: Intake should be limited to two or fewer drinks a day for men and one or less for women.
  • Obesity: Overweight people should try to lose weight using a combination of diet, exercise and counseling. The goal is a BMI of 18.5-24.9 and a waist line of 35 inches or less for women and 40 inches or less for men.
  • Exercise: 30 minutes of moderate exercise daily is recommended for those who are able. For patients with disabilities, a tailored exercise program to their capabilities should be arranged.
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