The choice depends on the particular medical disease, the side effects of the antidepressant, and other symptoms the patient may have. For example, for a terminally ill patient usually our first choice would be a stimulant because the onset of action is so much faster than an antidepressant. Time is of the essence. In a patient who had a myocardial infarction, we would generally avoid tricyclic antidepressants because they of their antiarrhythmic activity may increase mortality risks after myocardial infarction. Our next question.
First answer is with humility.
It is often not easy and these next couple of slides will illustrate some of the difficulties. Depression of course is characterized by mood disturbance. Some demented patients do have disturbance in mood as well, though of course, not all do. In general, both may have some difficulty with cognition, with their memory, concentration, and so on. The depressed patient typically complains about their cognitive difficulty.