Treatment with anti-depressant drugs of 61 inpatients admitted on account of stroke was studied. Eighteen patients (30%) were being so treated. Only 5 patients (17%) with dysphasia were being treated with anti-depressant drugs compared with 13 patients (41%) without dysphasia (P less than 0.05). Dosage levels used were generally low and only one patient had been referred for a psychiatric opinion. We suggest that the difference in anti-depressant usage is because dysphasic patients are more difficult to assess and therefore less likely to have depressive symptoms recognized and treatment given. We also think that psychiatric referral should be used more often for assessment of stroke patients and for advice about treatment.