Neuropsychiatric manifestation after a stroke: newly developed symptoms or side-effect of drug?

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Updated: May 19, 2026

A Middle Cerebral Artery Occlusion Technique for Inducing Post-stroke Depression in Rats
04:38

A Middle Cerebral Artery Occlusion Technique for Inducing Post-stroke Depression in Rats

Published on: May 22, 2019

Eng Chai Tan1, Noor Azah Aziz, Saharuddin Ahmad

  • 1Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Cheras, Malaysia. tce@ppukm.ukm.edu.my

BMJ Case Reports
|August 22, 2012
PubMed

A 55-year-old woman presented with sudden onset of left-sided body weakness and numbness, which was diagnosed as multifocal cerebral infarct with right thalamic bleed. She had concurrent hypertension, diabetes mellitus and chronic kidney disease. She suffered from central poststroke pain and reactive depression as poststroke complications, for which amitriptyline was prescribed. Unfortunately, she developed symptoms suggestive of mania and psychosis upon initiation of medications, which resolved upon withdrawal of amitriptyline. Amitriptyline is effective for treatment of poststroke pain and particularly useful in concomitant depression. Unexpectedly, this patient developed new psychopathologies after initiation of this medication. This case highlights the development of new psychopathologies that could be due to the antidepressant, underlying bipolar disorder or a complication of the stroke itself. Primary care providers need to actively enquire regarding neuropsychiatric symptoms because they can adversely affect the patient's quality of life as well as impede rehabilitation efforts.

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