Pathological crying and laughing: treatment with sertraline.

OBJECTIVE

To evaluate the efficacy of sertraline for treating pathological laughing and crying after stroke.

DESIGN

Case series.

SETTING

Inpatient rehabilitation units of a community and a tertiary-care hospital.

PATIENTS

One patient was a 62-year-old right-handed man who had two strokes approximately 2 years apart and had computed tomography consistent with a cerebral infarct involving the left middle cerebral artery branches in the left parietal lobe. A second patient was a 72-year-old right-handed man who had a right middle cerebral artery infarct. He had a questionable history of depression prior to the stroke.

INTERVENTION

Both patients had poststroke labile affect that was interfering with their rehabilitation. Sertraline was prescribed.

MAIN OUTCOME MEASURES

Pretreatment and posttreatment scores on the Pathological Crying and Laughing Scale and Functional Independent Measure.

RESULTS

Both patients showed significant improvement after taking sertraline-improvement that was reflected in their pretreatment and posttreatment scores on the Pathological Crying and Laughing Scale and Functional Independent Measure. The staff noted improvements in sleeping, eating, social interaction, and therapy participation. Both patients tolerated the sertraline well and had no significant side effects.