Differential diagnosis and treatment of depressive features in Down's syndrome: a case illustration

A 21-year-old young man with Down's syndrome presented with depressive symptoms and intermittent features of a Parkinsonian like syndrome. After treatment with amitriptyline for 18 months he slowly improved and almost regained his former personality. Neither imaging procedures nor clinical features were able to establish a definitive cause of this patient's depression. There was no evidence of either neurodegenerative or premature aging processes. Discussion focused on increasing clinicians' awareness of frequently undiagnosed but treatable depressive disorders within the Down's syndrome population.