Citalopram, depression and pseudo dementia: A neuropsychological case study

Mattos, Paulo

doi:10.1590/S0004-282X1995000500025

Abstracts

The author presents a case of (depressive) pseudo dementia, commenting on the clinical and neuropsychological findings before and after the use of citalopram, a serotoninergic anti depressive drug. The case portrays the current criticism about the old dichotomy between non-reversible ("functional") and reversible ("organic") dementia. The 73 year old woman initially diagnosed as pseudo demented showed some mild cognitive deterioration in neuropsychological evaluation after the improvement of her depressive symptoms. Some reasons for the divergent findings on pseudo dementia prognosis in the literature are proposed.

depression; dementia; pseudo dementia; citalopram

O autor apresenta um caso de pseudodemência depressiva, tecendo comentários sobre os achados clínicos e neuropsicológicos antes e depois do uso de citalopram, um agente serotoninérgico. O caso apresentado ilustra as críticas atuais acerca da antiga dicotomia entre demências reversíveis ("funcionais") e não-reversíveis ("orgânicas"). A paciente de 73 anos inicialmente diagnosticada como pseudodemente demonstrou algum grau de deterioração cognitiva em testes neuropsicológicos após a melhora dos sintomas depressivos. São sugeridas algumas razões para os achados divergentes com relação ao prognóstico da pseudodemência encontrados na literatura.

depressão; demência; pseudodemência; citalopram

Citalopram, depression and pseudo dementia. A neuropsychological case study

Citalopram, depressão e pseudodemência: um estudo neuropsicológico de caso

Paulo Mattos

MD, MSc, DSc, Professor of the Federal University of Rio de Janeiro (UFRJ), Coordinator of PIN (Projeto Integrado de Neuropsicologia)

SUMMARY

The author presents a case of (depressive) pseudo dementia, commenting on the clinical and neuropsychological findings before and after the use of citalopram, a serotoninergic anti depressive drug. The case portrays the current criticism about the old dichotomy between non-reversible ("functional") and reversible ("organic") dementia. The 73 year old woman initially diagnosed as pseudo demented showed some mild cognitive deterioration in neuropsychological evaluation after the improvement of her depressive symptoms. Some reasons for the divergent findings on pseudo dementia prognosis in the literature are proposed.

Key-words: depression, dementia, pseudo dementia, citalopram.

RESUMO

O autor apresenta um caso de pseudodemência depressiva, tecendo comentários sobre os achados clínicos e neuropsicológicos antes e depois do uso de citalopram, um agente serotoninérgico. O caso apresentado ilustra as críticas atuais acerca da antiga dicotomia entre demências reversíveis ("funcionais") e não-reversíveis ("orgânicas"). A paciente de 73 anos inicialmente diagnosticada como pseudodemente demonstrou algum grau de deterioração cognitiva em testes neuropsicológicos após a melhora dos sintomas depressivos. São sugeridas algumas razões para os achados divergentes com relação ao prognóstico da pseudodemência encontrados na literatura.

Palavras-chave: depressão, demência, pseudodemência, citalopram.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 2-agosto-1995.

Dr Paulo Matos - Avenida Venceslau Brás 71, Fundos - 22290-140 Rio de Janeiro RJ - Brasil.

1. Cassens G, Wolfe L, Zola M. The neuropsychology of depressions. J Neuropsych 1990, 2:202-213.
2. Emery V, Oxman T. The spectrum of depressive dementia In Emery V, Oxman T (eds). Dementia: presentations, differential diagnosis and nosology, New York: John Hopkins, 1994, p. 2S1-276.
3. Kral V. The relationship between senile dementia (Alzheimer type) and depression. Can J Psychiatry 1983, 28:304-306.
4. Kral V, Emery V. Long-term follow-up of depressive pseudomentia. Can J Psychiatry 1989, 34:445-447.
5. Lezak M. Neuropsychological assessment. Ed 3. New York: Oxford Univ Press, 199S p 429-497.
6. McAllister T, Price T.Severe depressive pseudo dementia with and without dementia. Am J Psychiatry 1982, 139:626-629.
7. Murphy E. The prognosis of depression in old age. Br J Psychiatry 1983, 142:111-119.
8. Rabins P, Merchant A, Nestadt G. Criteria for diagnosing reversible dementia caused by depression: validation by two-year follow-up. Br J Psychiatry 1984, 144:488-492.
9. Reifler B, Sherril K.Dementias: reversible and irreversibel. In Tasman A, Goldfinger SM, Kaufman CA (eds). Review of psychiatry. New York: American Psychiatric Press, 1990, Vol 9, p 220-231.
10. Rovner B, Broadhead J, Spencer M, Carson K, Folistein MF. Depression and Alzheimer's disease. Am J Psychiatry 1989, 146:350-353.
11. Sachdev P, Kilho LG. The Nondepressive dementias. In Emery V, Oxman T (eds). Dementia: presentations, differential diagnosis and nosology, New York: John Hopkins, 1994, p 277-297.
12. Wells C.Pseudo dementia. Am J Psychiatry 1979, 136: 895-900.

Publication Dates

Publication in this collection
08 Dec 2010
Date of issue
Dec 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Cassens G, Wolfe L, Zola M. The neuropsychology of depressions. J Neuropsych 1990, 2:202-213.

[2] 2. Emery V, Oxman T. The spectrum of depressive dementia In Emery V, Oxman T (eds). Dementia: presentations, differential diagnosis and nosology, New York: John Hopkins, 1994, p. 2S1-276.

[3] 3. Kral V. The relationship between senile dementia (Alzheimer type) and depression. Can J Psychiatry 1983, 28:304-306.

[4] 4. Kral V, Emery V. Long-term follow-up of depressive pseudomentia. Can J Psychiatry 1989, 34:445-447.

[5] 5. Lezak M. Neuropsychological assessment. Ed 3. New York: Oxford Univ Press, 199S p 429-497.

[6] 6. McAllister T, Price T.Severe depressive pseudo dementia with and without dementia. Am J Psychiatry 1982, 139:626-629.

[7] 7. Murphy E. The prognosis of depression in old age. Br J Psychiatry 1983, 142:111-119.

[8] 8. Rabins P, Merchant A, Nestadt G. Criteria for diagnosing reversible dementia caused by depression: validation by two-year follow-up. Br J Psychiatry 1984, 144:488-492.

[9] 9. Reifler B, Sherril K.Dementias: reversible and irreversibel. In Tasman A, Goldfinger SM, Kaufman CA (eds). Review of psychiatry. New York: American Psychiatric Press, 1990, Vol 9, p 220-231.

[10] 10. Rovner B, Broadhead J, Spencer M, Carson K, Folistein MF. Depression and Alzheimer's disease. Am J Psychiatry 1989, 146:350-353.

[11] 11. Sachdev P, Kilho LG. The Nondepressive dementias. In Emery V, Oxman T (eds). Dementia: presentations, differential diagnosis and nosology, New York: John Hopkins, 1994, p 277-297.

[12] 12. Wells C.Pseudo dementia. Am J Psychiatry 1979, 136: 895-900.