Post-stroke mania precipitated by withdrawal of antidepressant in an elderly patient with chronic major depression

Post-stroke mania is a rare neuropsychiatric complication that is observed in less than 1% cases of stroke and is less common than depression. Growing evidence suggests that it may be associated with the specific regions of the brain, preexisting subcortical atrophy, a family history of mood disorders, and chronic vascular burden. However, the development of bipolar disorder after stroke is uncommon in a patient with chronic major depression. In this report, we present the case of an elderly woman with depression and chronic vascular burden; she experienced her first episode of mania after a lacunar infarct on the right side and the withdrawal of antidepressant therapy.