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A Case with Striatocapsular Infarction that Developed Severe Depression which was Successfully Treated with Olanzapine and Paroxetine

  1. Shinji Tagami1,2,*,
  2. Hisayoshi Niigawa1,
  3. Junko Suzuki1,
  4. Yuriko Mizoguchi1,
  5. Ryosuke Mikiya1,
  6. Yasuyuki Miyamae1,
  7. Masatoshi Takeda2

Article first published online: 20 AUG 2007

DOI: 10.1111/j.1479-8301.2002.tb00035.x

Issue

Psychogeriatrics

Psychogeriatrics

Volume 2, Issue 1, pages 62–67, March 2002

Additional Information

How to Cite

Tagami, S., Niigawa, H., Suzuki, J., Mizoguchi, Y., Mikiya, R., Miyamae, Y. and Takeda, M. (2002), A Case with Striatocapsular Infarction that Developed Severe Depression which was Successfully Treated with Olanzapine and Paroxetine. Psychogeriatrics, 2: 62–67. doi: 10.1111/j.1479-8301.2002.tb00035.x

Author Information

  1. 1

    *, Department of Neuropsychiatry, Bell Land General Hospital

  2. 2

    *, Department of Post-Genomics and diseases, Division of Psychiatry and Behavioral Proteomics, Osaka University Graduate School of Medicine D3

* Department of Neuropsychiatry, Bell Land General Hospital, 500–3 Higashiyama, Sakai-shi, Osaka 599–8247, JAPAN.

Publication History

  1. Issue published online: 20 AUG 2007
  2. Article first published online: 20 AUG 2007
  3. Received February 4, 2002, revision accepted March, 18, 2002.

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Keywords:

  • poststroke depression (PSD);
  • treatment-resistant depression (TRD);
  • multiacting receptor targeted agent (MARTA);
  • selective serotonin reuptake inhibitor (SSRI)

Abstract: It is well known that depression can often occur after various kinds of cerebrovascular disorders and that antidepressants including selective serotonin reuptake inhibitor (SSRI) are effective against poststroke depression (PSD). But some cases of PSD, as in the case of endogenous depression, can be treatment-resistant. Here we report a case that developed severe appetite loss and depression one month after the onset of left-sided Striatocapsular infarction. The appetite loss was so severe that transnasal nutrition was necessary. Amantadine or sulpiride was administered to him, but neither of them were effective. The maximum tolerable dose of paroxetine gave him slight improvement, but it was not enough. Recently, it has been reported that a combination of olanzapine, which is a kind of multi-acting receptor targeted agent (MARTA), and fluoxetine, a kind of SSRI, demonstrated superior efficacy for treatment-resistant depression (TRD) compared to either agent alone. In our case, a combination of olanzapine and paroxetine showed a drastic improvement in appetite loss and depression. The result suggested that a combination of MARTA and SSRI can be as effective in treatment-resistant PSD as in endogenous TRD.

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