Two cases are presented to illustrate some of the issues that arise in the management of patients diagnosed as suffering from the dementia syndrome of depression (Pseudodementia). Case 1 illustrates the dilemma of relatively normal autopsy findings in the brain in a patient presenting with a history of depression and dementia. Case 2 deals with a patient successfully treated for depression 14 years after the diagnosis of presenile dementia. Issues raised include the problem of labelling and the Rip Van Winkle situation of unanticipated recovery 14 years after this diagnosis was made. A planned approach to the treatment of pseudodementia systematically exploring available treatment options is recommended.
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