Case Report: Psychotic Depression with Pseudodementia Misdiagnosed as Dementia Remitted with TCA

Abstract

Epidemiological research has indicated that elderly patients with depression are at increased risk of subsequent dementia including Alzheimer’s disease. In addition, several studies have also shown that depressive pseudodementia may well develop into irreversible dementia. It is a matter of course, however, that all depressive patients with pseudodementia do not progress to irreversible dementia. The present case is an elderly woman with psychotic depression who was misdiagnosed with dementia because of poor response to serotonin selective reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) as well as a manifestation of moderate cognitive impairment. She was remitted with pharmacotherapy by tricyclic antidepressant (TCA), with no cognitive problems. Psychiatrists should take care not to give too much weight to certain evidence that pseudodementia is a strong predictor of dementia, and should observe individual depressive patients carefully and treat them in any possible way including with TCA or electroconvulsive therapy.