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What Causes Severe Depression Post Recovery From Stroke?

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Posted on Mon, 7 Mar 2016
Question: My wife has suffered two stroke s this past year. Fortunately not to debilitating, however she is withdrawing,non communicative for the most part, recently she had a urinary tract infection, she is a young 73 ,used to be a high energy person, even after her strokes she would communicate with me. Now since her UTI and treatment, she won't talk much with me. She initially was put on the wrong antibiotic, the ER called after three days admitting they put her on the wrong antibiotic, said what she had taken would not hurt her and prescribed a different antibiotic that would target her type of infection.She still is withdrawing, She takes thyroid,blood pressure,and anti depression meds since her strokes, she also has trouble holding her bowels,no cancer,has had colonoscopy,CT,mri,blood work.
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Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

Since there have been two strokes I assume some area of her brain has been damaged. Luckily, since you say she's not disabled it hasn't involved the areas responsible for speech and motor function, however there are certain areas of the brain like the frontal or temporal lobes which while not causing visible motor disability are very much involved in mood and behavior. So if the two strokes involved such areas the changes may be directly related to them, apathy is common symptom particularly of frontal lobe damage.

The other possible cause, either alone or together with the direct brain damage, may be the changes in her lifestyle she has perhaps had to make. In a previously active, healthy person, having to undergo frequent visits, medications etc may contribute to mood disorders. You mention yourself she's been diagnosed with depression which is common in after stroke patients.
At times also depends on medications, some antidepressants may cause sedation, you do not mention what she takes, but it is a possibility to be considered. I do not think it's directly related to the antibiotics though, even considering the error made in their description.

Regarding therapy, well apart from antidepressants there is no approved therapy. There have been some suggestions on use of stimulants like low dose amphetamines, ritalin, but they are not approved, might have side effects so used only in certain studies.
Otherwise it is a question of getting her to be as active as possible, out of the house, participation in support groups and psychotherapy.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

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What Causes Severe Depression Post Recovery From Stroke?

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. Since there have been two strokes I assume some area of her brain has been damaged. Luckily, since you say she's not disabled it hasn't involved the areas responsible for speech and motor function, however there are certain areas of the brain like the frontal or temporal lobes which while not causing visible motor disability are very much involved in mood and behavior. So if the two strokes involved such areas the changes may be directly related to them, apathy is common symptom particularly of frontal lobe damage. The other possible cause, either alone or together with the direct brain damage, may be the changes in her lifestyle she has perhaps had to make. In a previously active, healthy person, having to undergo frequent visits, medications etc may contribute to mood disorders. You mention yourself she's been diagnosed with depression which is common in after stroke patients. At times also depends on medications, some antidepressants may cause sedation, you do not mention what she takes, but it is a possibility to be considered. I do not think it's directly related to the antibiotics though, even considering the error made in their description. Regarding therapy, well apart from antidepressants there is no approved therapy. There have been some suggestions on use of stimulants like low dose amphetamines, ritalin, but they are not approved, might have side effects so used only in certain studies. Otherwise it is a question of getting her to be as active as possible, out of the house, participation in support groups and psychotherapy. I remain at your disposal for other questions.