CONCLUSIONS
Cognitive impairment research, as it relates to depression, is still emerging. Future studies and standards should move toward standardized assessment and evaluation of cognitive outcomes in patients with depression. Multiple serotonin receptors will likely have a role in treating depression, and multiple neurotransmitter interactions involving glutamate and dopamine probably contribute to improving cognitive symptoms of depression. Antidepressant properties that target cognition are an emerging topic that needs further study. Nonpharmacologic strategies should also be entertained. Psychotherapy, the mainstay in treatment for depression, should always be considered in the holistic care of patients suffering from depression. Discussing cognitive deficits and treatment options, including medication, therapy, and referral, with patients such as Hilda is important, considering current evolving evidence. As with all cases of depression, it is important to rule out other causes of depression and cognitive deficits and consider psychiatric referral. A case like hers shows that shared decision making is an ideal strategy for communicating “best practices.”
