Depressed and confused, and dizzy while walking the dog
Mr. M, age 73, feels light-headed and has difficulty following conversations. He has a history of depression, cardiovascular disease, and visual problems. What could be causing his symptoms?
Bottom Line
Although psychiatric symptoms are not part of the diagnostic criteria for multiple system atrophy (MSA), they may serve as a clue to consider when they occur with other MSA symptoms. Evaluate the importance of psychiatric symptoms in terms of the whole picture of the patient. Although the diagnosis might not alter the patient’s course, it can allow family members to understand the patient’s condition and prepare for complications that will arise.
Related Resources
• The MSA Coalition. www.multiplesystematrophy.org.
• National Institute of Neurological Disorders and Stroke. Multiple system atrophy fact sheet. www.ninds.nih.gov/disorders/msa/detailmsa.htm.
• Wenning GK, Fanciulli A, eds. Multiple system atrophy. Vienna, Austria: Springer-Verlag Wien; 2014.
Drug Brand Names
Bupropion • Wellbutrin Lithium • Eskalith, Lithobid
Carbamazepine • Tegretol Methylphenidate • Ritalin
Desvenlafaxine • Pristiq Paroxetine • Paxil
Donepezil • Aricept Travoprost • Travatan
Escitalopram • Lexapro Trazodone • Desyrel, Oleptro
Fludrocortisone • Florinef Topiramate • Topamax
Fluoxetine • Prozac
Disclosures
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
