Depression in Neurological Practice: Diagnosis, Treatment, Implications

Ambulatory prevalence rates for significant depressive syndromes in general neurology clinics are quite high, in the range of 15 to 20% of clinic attendees. These depressive syndromes are a source of considerable morbidity and even mortality for the patients who suffer from them. Depression is a treatable syndrome, but there are not enough psychiatrists to administer all the treatments. Inevitably, many neurologists will become involved with some antidepressant therapies. In this article, I review a series of steps that can be used by neurologists to diagnose and treat the depressive disorders that occur in their practices. The Goldman algorithm for the treatment of depression is also presented as a therapeutic tool for practicing neurologists.