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The treatment of aphasia secondary to stroke should take into account the multiple factors that may influence recovery, such as the characteristics of aphasia, psychological morbidity’s, and physical and emotional impact on quality of life of patients. Physicians should avoid, wherever possible, the use of drugs that can have deleterious effects on recovery potential, reducing plastic reorganization of the brain, such as haloperidol and phenobarbital. It is also necessary to recognize co morbid psychiatric disorders in early stages to treat them before prolonged assessments of aphasia or implement speech / language and speech, and that these conditions may decrease the ability of suboptimal care. The treatment of aphasia include nonpharmacologic and pharmacologic therapies.

Nonpharmacologic Therapies

Among non-pharmacological treatment therapy and speech language are the main therapeutic support aphasia. But in recent decades controversies arose about its effectiveness, due to the divergent results between studies that presumably were due to methodological problems that make comparisons difficult. In three meta-analysis (one in 1998, which included 55 studies, and the remaining two made in 2003) found that intensive therapy and speech language in a short period of time had better outcomes than less intensive regimens over long periods. These findings were consistent with those reported in the literature reviews on the treatment of aphasia, but the benefits of speech therapy and speech appear smaller when only randomized studies were analyzed and controlled. In a systematic analysis of 60 randomized controlled trials conducted in 2000 could not be established if the formal language therapy and speech therapy were superior to informal support. However, only 12 of 60 trials met the selection criteria for analysis, although not recent enough, and only 2 of 12 had been included in the large meta-analysis in 1998. Thus, the divergent results could be due, at least in part, to the analysis of different populations. Although randomized controlled trials are the gold standard for evaluating the effectiveness of treatments, it has been postulated that do not provide useful information about the effectiveness of aphasia therapy.

Recently became popular specific rehabilitation techniques motivated models based descriptions of language deficiencies in individual cases. These treatments are offered primarily to patients with chronic aphasia after reaching a plateau with conventional therapies. Some assisted therapies theory and therapy of the restriction and induction, modal therapy and multi modal strategies showed positive results for specific objectives with variable spread to other areas of language. Other rehabilitation techniques also appear to be promising. Aphasia therapy computer assisted was effective as adjudicative therapy in chronic aphasia. The treatment of aphasia in community-based programs significantly improved the deterioration of language and functional communication in patients with acute and chronic aphasia. The rehabilitation of individuals with severe aphasia should not be guided entirely by the cognitive theory, but should include broader strategies.