J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-304764
  • Neurological picture


  1. Tomás Ortiz2
  1. 1Department of Neuropsychiatry, University Hospital of La Ribera, Valencia, Spain
  2. 2Magnetoencephalography Unit, Complutense University of Madrid, Madrid, Spain
  1. Correspondence to Dr Carlos Miró, Department of Neuropsychiatry, University Hospital of La Ribera, Carretera de Corbera Km. 1, Alzira, Valencia 46600, Spain; cmiro{at}
  • Received 11 December 2012
  • Revised 31 January 2013
  • Accepted 4 February 2013
  • Published Online First 27 February 2013

A 39-year-old-woman was admitted to the hospital after attempting to commit suicide by jumping off a bridge. She had been diagnosed with trigeminal neuralgia at the age of 19 years, which was refractory to medical therapy with carbamazepine and high doses of amitriptyline. She preferred to be self-medicated with benzodiazepines and alcohol to relieve her pain since she was 21 years old; nevertheless, such substance abuse led to impairment of depressive disorder induced by her rebel facial pain.

On admission, our patient fulfilled the criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., …

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