How to manage depression and psychosis in Alzheimer's disease

Depression and psychosis each occur in about 30 to 50% of patients with Alzheimer's disease (AD). Depressive syndromes range from grieving and mild depressive symptoms to major depression. Depression can also mimic the signs and symptoms of AD, a condition known as dementia syndrome of depression. Psychotic syndromes include paranoid delusions, misidentification syndrome, and hallucinations. The diagnosis of both depression and psychosis is based on a careful history and a mental status examination. Treatment includes psychosocial intervention and, when symptoms are severe, drug therapy. The newer antidepressants are recommended for depressive syndromes, whereas psychosis is treated with high-potency neuroleptics.