{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:10:06Z","timestamp":1756365006325,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2012-006518","type":"journal-article","created":{"date-parts":[[2012,8,20]],"date-time":"2012-08-20T11:53:23Z","timestamp":1345463603000},"page":"bcr2012006518","source":"Crossref","is-referenced-by-count":1,"title":["Neuropsychiatric manifestation after a stroke: newly developed symptoms or side-effect of drug?"],"prefix":"10.1136","volume":"2012","author":[{"given":"Eng Chai","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Cheras, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor Azah","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Cheras, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saharuddin","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Cheras, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,8,20]]},"reference":[{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(00)71168-6"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.9.1467"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.12.2995"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.4","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.70.9.785"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.61.5.679"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.6","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31819d644c"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF00630290"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1399-5618.2003.00067.x"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2004.10.012"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.10","first-page":"43","article-title":"Diagnostic issues in bipolar disorder","volume":"13","author":"Angst","year":"2003","journal-title":"Public Health"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.11","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200202000-00010"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000327032","article-title":"Mania and stroke: a systematic review","volume":"32","author":"Santos","year":"2011","journal-title":"Cerebrovasc Dis"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(03)00423-2"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.14","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2010.505997"},{"key":"2025082723360297000_2012.aug14_2.bcr2012006518.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-8343(98)00020-6"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-006518","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:36:15Z","timestamp":1756362975000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-006518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,20]]},"references-count":15,"alternative-id":["10.1136\/bcr-2012-006518"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-006518","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2012,8,20]]}}}