Treatment of depression when it presents along or during the course of a neurodegenerative condition like Alzheimer’s dementia is essentially the same as treatment of primary depression. The most commonly prescribed drugs are those which belong to two classes: tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI).

Q: Is it sometimes difficult to ascertain whether or not a patient with Alzheimer’s has depression?

It is indeed difficult to determine with certainty whether a patient with Alzheimer’s dementia also has superimposed depression. Also what is the optimum treatment for someone who might have an underlying primary dementia such as Alzhemier’s disease but also has superimposed incompletely treated depression? Most doctors would agree that her depression needs to be treated more aggressively and then the primary dementia should be reassessed.

Q: What expert advice do you give to your patients with Alzheimer’s or their caregivers when you suspect that your patient also has symptoms of depression?

I invariably advise aggressive treatment of the depression and then a reassessment of the patient’s cognitive status.

Q: Is there anything that the patient diagnosed with dementia symptoms or Alzheimer’s disease can do to prevent depression?

A very interesting question and let me answer it this way. Depression is bad for the brain and I strongly believe that a healthy brain and a healthy mind go hand in hand. You cannot have one at the expense of the other. Since depression is treatable and dementia as of now is not, it is very important that depression should be identified and aggressively treated in a patient suffering from disorders of memory.

Inner peace, calmness, introspection, tranquility are essential qualities that nurture the mind and help to maintain its internal equilibrium. Meditation, spirituality and doing yoga are ways by which that elusive inner peace can be obtained ensuring a healthy mind and brain.

Thank you for your thoughtful questions. I hope your readers find my answers equally insightful. Wishing you all a healthy brain and a healthy mind.

Nitin Sethi, MD Assistant Professor of Neurology

Course Director Resident Clinical Neurophysiology Rotation

New York-Presbyterian Hospital Weill Cornell Medical Center

Director and Chief Coordinator Brain Care Foundation (http://braincarefoundation.com)