title: Mirtazapine treatment for pathological laughing and crying after stroke.
abstract: Selective serotonin reuptake inhibitors (SSRIs) have been recognized as the treatment of choice for pathological laughing and crying (PLC), which is a common, distressing condition that follows stroke. There have been few reports about other treatment options for PLC. Here, the authors report rapid responses to mirtazapine in two patients with poststroke PLC who failed to respond to SSRIs or bupropion. In the first case, a 63-year-old woman with severe long-standing crying spells that had persisted for 3 months responded well to low-dose mirtazapine within a few days; she could not tolerate citalopram or sertraline. In the second case, both the laughing and crying spells of a 64-year-old woman were improved within a few days of mirtazapine administration, after they had not responded to bupropion. This is one of the first reports to suggest that mirtazapine may be an alternative to SSRIs for treating poststroke PLC.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Repiblic of Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Lim
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Yang
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D016642:Bupropion / Q000627:therapeutic use; D003448:Crying / Q000523:psychology*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007845:Laughter / Q000523:psychology*; D008140:Lorazepam / Q000627:therapeutic use; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D019635:Neurosurgical Procedures; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000150:complications* / Q000523:psychology*; D000071939:Stroke Rehabilitation; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery
chemical_list: D000928:Antidepressive Agents; D018765:Dopamine Uptake Inhibitors; D006993:Hypnotics and Sedatives; D016642:Bupropion; D008803:Mianserin; D000078785:Mirtazapine; D008140:Lorazepam