Abstract
In February, 2005, a 68-year-old woman, who had no history of psychiatric illness, presented to our department with a major depressive disorder, with moderate sadness, inner tension, difficulty in concentrating, severe sleep impairment, appetite loss, and pessimistic thoughts. She had atrial fibrillation (AF) which had been treated with 0·25 mg digoxin daily and 1 mg warfarin daily for 2 years (INR 1·7). There were no abnormal physiological findings except a slightly raised serum creatinine concentration (106 μmol/L).
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