dothiepin-hydrochloride and Intellectual-Disability

A 32-year-old chronically relapsing depressed male patient with a mild mental handicap had tried different forms of pharmacotherapy which were either not tolerated or failed to prevent recurrences of episodes of psychotic depression. The use of maintenance ECT as the mainstay of the therapeutic regime led to a marked consistent clinical improvement.

Topics: Adult; Child of Impaired Parents; Chronic Disease; Combined Modality Therapy; Depressive Disorder; Dothiepin; Electroconvulsive Therapy; Hospitalization; Humans; Intellectual Disability; Male; Recurrence; Suicide, Attempted

Nineteen mentally handicapped subjects who were referred to the service with clinically significant depression were assessed with a view to determining the value of the dexamethasone suppression test (DST) in clinical diagnosis and in predicting response to antidepressant treatment. They were assessed initially and then 3 months after they had been treated with a tricyclic antidepressant. It was found that a significant proportion had an abnormal DST response which reversed after recovery in some but not in others. Non-reversal was more likely to occur in the more severely handicapped patients. It was concluded that DST was of little value as a diagnostic tool for the detection of depression in mentally handicapped subjects.

Topics: Adolescent; Adult; Antidepressive Agents, Tricyclic; Depressive Disorder; Dexamethasone; Dothiepin; Female; Humans; Hydrocortisone; Intellectual Disability; Male; Middle Aged