Ricardo Barcelos
Médico psiquiatra, pesquisador do Projeto Terceira Idade (Proter) do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IPq-HC-FMUSP).
Juliano Faria
Médico doutorando em Radiologia pela Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp)
Paulo Grossi
Médico cardiologista coordenador do Centro de Terapia Intensiva do Hospital Geral Santa Lúcia (HSL), Divinópolis, MG.
Marco Antonio Moscoso Aparício
Médico psiquiatra, colaborador do Projeto Terceira Idade (Proter) do IPq-HC-FMUSP
Cássio M. C. Bottino
Médico-assistente e coordenador do Projeto Terceira Idade (Proter) do IPq-HC-FMUSP e professor de pós-graduação do Departamento de Psiquiatria da FMUSP
Abstract:
Context: Among neuropsychiatric disorders caused by cerebrovascular factors, vascular depression is diagnosed in a small degree by general practitioners, causing morbid-mortality increase in elderly. Case report: That is a case of a 67 year-old-man with partial response after treatment with a Selective Serotonin Receptors Inhibitor, and severe autonomic adverse effects with other antidepressants. The addition of rivastigmine to citalopram resulted in a therapeutic success, with a reduction of 23 to 7 points on the Hamilton Depressive Scale (HAM-D). Discussion: The result obtained brings new perspectives to the treatment of vascular depression, providing that randomized controlled trials with larger sample sizes confirm the positive effect of the addition of a cholinesterase inhibitor to antidepressants in the treatment of these patients.
Keywords:Vascular depression, vascular dementia, Alzheimer’s disease, stroke, neuroimaging.