Cognitive Symptoms: The Border Between Dementia and Depression, a Report of One Case

Abstract

Introduction

Twenty percent of people aged over 80 have a serious dementia. Cognition disturbances are present both in depressive disorder and dementia. Vortioxetine is a new antidepressant with a multi-modal mechanism of action, being one of the antidepressant with more procholinergic action.

Aims

to know the efficacy of vortioxetine in elder people with cognitive disturbances due to both pathologies: depression and dementia.

Methods

It is described the result of using vortioxetine in one elder woman with dementia and affective symptoms with no clinical improvement after using two classical antidepressants.

Results

Woman aged 82 without psychiatric history came to our consultation in April 2016. She had been diagnosed with dementia last year by a neurologist and she had started treatment with Donepezile 10 mg/d. Six months after this diagnosis she complained of depressive mood and faster deterioration of her previous cognition disturbances in terms of functionality level and autonomy, so her neurologist prescribed escitalopram until 10 mg/d and mirtazapine until 30 mg/d without clinical improvement. After first exploration, we decided starting treatment with vortioxetine 10 mg/d and withdraw previous antidepressants. Next week she complained of nausea and vomiting so we reduced the dose to 5 mg/d with good tolerance after that moment. Six months later her depressive mood had improved and her family remarked she had a little more autonomy and more desire to do things.

Conclusions

Vortioixetine might be an effective and safe option in elder people who have cognitive disturbances due to mood disorder and/or dementia, probably because of its procholinergic action.

Disclosure of interest

The authors have not supplied their declaration of competing interest.