67-year-old man with psyc...

A 67-year-old man with psychiatric symptoms visited the clinic. He had H/o suffering from depression, increased appetite, anxiety, daytime tiredness, loss of sleep. All these made him detach himself socially. He had a BMI of 28.9 kg/m2 and BP (130/100 mm Hg). His routine blood analysis reports were regular. The person had no family history of neurogenerative disorders or autoimmune disorders. The patient restrained himself from smoking and alcohol.

The patient had bags under his eyes with reduced facial expression. He had no suicidal tendencies. His sleep pattern was rapid sleep onset but never satisfactory. His GP had prescribed him benzodiazepine hypnotics, but it produced no improvement. He later started on citalopram 20 mg O.D daily, a first-line serotonergic antidepressant. This treatment made him lose 7 kg bodyweight, which ultimately made him feel better. The patient also takes simvastatin 40 mg O.D daily.

The post-traumatic stress disorder was ruled out in this case as the patient did not meet DSM-5 criteria, but he met the depressive disorder criteria. In addition, there was no slow-wave sleep pattern indicating a distorted sleep pattern. The Apnoea–Hypopnoea Index (AHI) was found to be 57.