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Strokes cause a variety of cognitive impairments that may include aphasia. Speech-language pathologists and aphasiologists encounter an increasing number of patients treated with pharmacological agents. This review describes research regarding four main approaches to neuropharmacological intervention: pharmacotherapy or drugs used to facilitate language improvements following stroke, neuroreplacement to restore compromised levels of neurotransmitters, neuroprotective agents that minimise the extent of cell loss in the brain, and thrombolytic agents to restore blood flow to regions of the brain that have become ischaemic following stroke. Studies in each major approach are reviewed.