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Copperfield: I’ll stick with the antidepressants, thanks

I don’t mean to sound dementist. But I’m really not sure the news that antidepressants are ineffective in depression in demented patients is anything for us to get too deranged about 

For a start, confidently diagnosing depression in a demented patient is nigh on impossible for all the obvious reasons (such as patients not knowing if they’ve lost interest in things as they can’t recall what those interests are, and if they can, by the time they’ve remembered them, they’ve forgotten the question) and for some more subtle ones (emotional wobbliness can in itself be a feature of dementia).

Add to that little lot the fact that severe depression can masquerade as dementia (depressive pseudodementia) and that the planned DES to screen for dementia could well make a whole load of people who might or might not have early dementia pretty depressed (dementive pseudodepression) and you have a situation which is very likely to impact on our own MMTS/PHQ.

So when I say it’s nothing to get deranged about what I really mean is that we should carry on in our own sweet pragmatic way with a judicious trial of antidepressants as appropriate. They might help the patients, too.


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