A 39-year-old married man presented to the psychiatry ouTPatient department with complaints of tiredness, sadness of mood, difficulty concentrating, and disturbed biological functions for the last 5 months. There was no significant past or family history. General physical examination and systemic examination, including neurological examination was within normal limits. Mental status examination revealed depressed affect, with ideas of hopelessness and worthlessness. A diagnosis of depressive episode, moderate, was made according to ICD-10. His routine investigations, including thyroid-function tests, were normal. He was started on escitalopram 10 mg per day along with clonazepam 1 mg per day. Gradually, his clonazepam was stopped, and escitalopram was increased to 20 mg per day after a period of 1 month. The patient reported improvement in depressive symptoms. He was maintaining improvement on this treatment. After 6 months of escitalopram therapy, the patient presented to the emergency department with complaints of deviation of mouth to right side, drooling of saliva from the mouth, and difficulty in speaking. Neurological examination revealed left 7th supranuclear palsy with no other abnormality. CT scan of the head revealed hypodensity involving both gray and white matter of the right temporo-parietal (TP) region, with a CT value of 19-20HU, suggestive of right TP infarct. He was further evaluated for the risk factors of stroke. He was a nonsmoker, normotensive, non-diabetic man with no previous history of any cardiac illness or migraine. There was no history of using any medication other than escitalopram. There was no family history of any cardiac illness. Serum tests for total blood count, renal and hepatic functions, sedimentation rate, HIV, lipid profile, anti-nuclear antibodies, serum vitamin b12 levels, antidsDNA, and coagulation profile were all found to be in the normal range. ECG and Chest X-ray were also normal. Echocardiography done revealed mitral valve prolapse (MVP). Magnetic resonance angiography was also done and was normal. The patient improved gradually over the next 15 days and was then started on amitriptyline for mild depressive symptoms. He has been maintaining improvement on this for the last 6 months of follow-up.