Poststroke depression is very common and has been reported in as many as 40∼50% of poststroke patients. The fluoxetine is one of the most frequently prescribed drugs for the treatment of poststroke depression. This serotonin selective reuptake inhibitor, known as generally safe and well tolerated drug, has been recently reported to induce mania. We report a case of fluoxetine-induced mania. A 64 year-old male, who has taken 10 mg of fluoxetine daily due to poststroke depression, presented elevated mood, hyperactivity, regressed behavior, excessive planning, sleep deterioration, and talkativeness abruptly. We were suspicious of fluoxetine- induced manic state and discontinued immediately fluoxetine without prescription of mood stabilizer. His symptoms had been ceased over two weeks. (J Korean Acad Rehab Med 2008; 32: 116-118)

Objective
To investigate the correlation between poststroke depression (PSD) and the cognitive impairment in the patients with subacute stroke. Method: The subjects were 53 patients with cerebral infarction (n=28) and cerebral hemorrhage (n=25). These patients had a mean age of 64.3. The mean onset time was 2.7 months. The location of stroke was in the right hemisphere in 24 subjects, left hemisphere in 23, and bilateral in 6. The severity of PSD was evaluated by Beck Depression Inventory (BDI), Korean Geriatric Depression Scale (KGDS), and Hamilton Rating Scale for Depression (HRS-D) and the evaluation of cognitive impairments was based on Computerized Neuro-psychological Test (CNT), Mini-Mental State Examination (MMSE). The Pearson correlation was used as a measure of the strength of association between cognitive impairments and PSD. Independent t-tests were calculated to compare differences in cognitive functioning according to hemispheric involvement. Results: PSD was diagnosed in 33 of 53 patients by the BDI, in 28 of 43 patients by the KGDS and in 22 of 45 patients by the HRS-D. Scores in the verbal and visual learning domains of the CNT were significantly correlated with scores on the BDI, KGDS, and HRS-D, but scores on the MMSE were unrelated to any of these measures of depression. Conclusion: We suggest the use of the CNT in poststroke depression patients could be a useful tool from the viewpoint of differentiation of PSD patients with or without cognitive impairment and the diagnosis for poststroke depression should be conducted by self rating and objective assessments. (J Korean Acad Rehab Med 2009; 33: 527-532)