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Clinical Crossroads Update
January 3, 2001

An 82-Year-Old Woman With Mood Changes Following a Stroke, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;285(1):80. doi:10.1001/jama.285.1.80

In November 1999, Robert G. Robinson, MD, discussed an 82-year-old woman who experienced symptoms of depression following a right internal capsular stroke.1 The stroke left Mrs K, the patient, with a left-sided hemiparesis and restrictions in her activities of daily living. During the first 3 months after the acute stroke, she had episodic changes in her mood and behavior. She also had suicidal thoughts of wishing to die in her sleep. She expressed sadness and hopelessness and refused physical therapy. Her appetite was poor, and she had lost some weight. Dr W, her physician, initially prescribed fluoxetine hydrochloride for Mrs K, but had switched her medication to sertraline hydrochloride 1 month before the conference.

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