Clinical case about a 62 year old patient, diagnosed with mixed anxiety-depressive disorder. In current treatment with Paroxetine, Clorazepate and Trazodone. She presents low spirits secondary to a neurological process (stroke + amyloid angiopathy+ epilepsy+ cognitive impairment) and difficulties in performing daily activities. Her daughter reports that she is totally dependent, she spends the whole day in bed. On examination we observe a dull mood, without emotional reactivity. Lack of motivation. Psychomotor slowness.Significant cognitive impairment with difficulties in performing daily activities. Mnesic faults.

Clinical case shows radiological and cognitive improvement with vortioxetine

Last diagnoses: August 2020: HSA OF THE FRONTAL AND PARIETAL GROOVES RIGHTS September 2020:SYMPTOMATIC FOCAL EPILEPSY SECONDARY TO LEFT FRONTOPARIETAL INTRAPARENCHIMATOSUS HEMATOMA December 2020:MYELOID ANGIOPATIA February 2021:SUBARACHNOID HEMORRHAGE March 2021:DEPRESSIVE DISORDER SECONDARY TO MEDICAL ILLNESS - MODERATE COGNITIVE IMPAIRMENT

Spectacular improvement in mood and cognitive deficit. The family reports that after 5 days they noticed the change. They find her more lively, she has returned to doing housework and is autonomous for day-to-day life. She has regained her memory and performed calculation exercises on a daily. The patient says that she has returned to being her usual self, “before I felt like a mummy and now I have finally woken up, it seems like a miracle”.

It has improved much with change of antidepressant, from paroxetine to vortioxetine in patient who show in cranial MRI: New-onset lesion in the right frontal lobe attributable and subarachnoid hemorrhage located in convex furrows ,radiological findings in favor of amyloid angiopathy

No significant relationships.