Post-stroke depression
In spite of the difficulties associated with the diagnosis of depression after stroke, this mood disorder is common in patients who have been the victim of a stroke in the preceding two years. Major depressive disorder has been demonstrated in at least 20 to 30% of outpatients, and possibly even occurs in a higher percentage of hospitalized patients. According to certain authors, a strong relationship exists between the presence and severity of post-stroke major depression and lesion location in the proximity of the left frontal pole. It has been shown that tricyclic antidepressants are efficacious in depression after stroke. However, some patients experience too many side-effects from this treatment. So far, it has not been sufficiently established that the so-called post-stroke depression should be exclusively considered as a specific complication of the brain lesion, and that as a consequence, only minor importance should be attributed to psychological and social factors in the pathogenesis and treatment of this condition.