Stroke and depression: clinical features and treatment.

Cerebrovascular diseases are associated with a high incidence of depressive disorder, but despite this high level of comorbidity, depression appears to go largely unrecognized and untreated. This problem may have serious consequences as depressive disorder worsens the prognosis eitherquoad vitam orquoad valetudinem, increases medical costs, and delays the return to work or to a normal social functioning. If previous treatments with traditional antidepressants such as TCAs were difficult in these patients because of the known cardiovascular and anticholinergic side effects, new antide-pressants (such as SSRIs, noradrenergic and specific serotonine antidepressants (NaSSAs), noradrenergic reuptake inhibitors (NARIs) may offer therapeutic advantages as they have little or no effect on cardiac conduction, only transient or no effect on orthostatic hypotension, and no effect on cognitive performances.