ABSTRACT
A 75-year-old widower was admitted to a chronic care hospital following a major stroke causing right-sided hemiplegia. In the post-stroke period he was noted to be emotionally labile and tearful and was started on amitriptyline with increasing doses up to 150 mg daily. Psychiatric consultation was requested because of persistent lability and mood symptomatology. On initial assessment, he showed evidence of marked disorientation to time and place. He was in a hospital in London, England and while sitting in front of the lift (elevator) he imagined that he was in a tube (subway) station.
