Reversible Dementia and Affective Disorder: The Rip Van Winkle Syndrome.
The diagnostic separation of the reversible dementia of an affective disorder from the dementia secondary to structural brain pathology remains a clinical challenge. A 58-year-old woman had been diagnosed as having Alzheimer's dementia for 9 years before antidepressant treatment with electroconvulsive therapy (ECT) resolved the dementia syndrome. The patient has functioned well for 8 years on maintenance treatment with lithium, with ECT given every 7-8 weeks. By the summer of 1993, she had undergone 132 ECT. Until specific and reliable pre-morbid tests for the diagnosis of irreversible dementias of the Alzheimer's and multiinfarct types are developed, antidepressant treatment trials are encouraged in elderly patients with a dementia syndrome. Extensive maintenance ECT schedules are safe.
Bright-Long
Lory E.
LE
Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, and the Psychiatric Service, University Hospital, Stony Brook, New York, USA.
Fink
Max
M