Differential diagnosis and treatment of depressive features in Down's syndrome: a case illustration.

Doctors followed one young man with Down syndrome who looked sad, slept poorly, and lost interest in his day program. They gave a full medical check, started the antidepressant amitriptyline, and watched him for weeks.

This 1990 report is a single-case study, so it shows what can happen, not what always happens.

The young man's mood, sleep, and participation improved markedly on the medication. No side effects were noted during the study period.

Sturmey et al. (1996) extends this hopeful picture by tracking a larger group for one year. They found most adults with Down syndrome and depression stayed depressed and kept low adaptive scores, even with treatment.

Spanoudis et al. (2011) pull both papers together in a narrative review. They say depression in Down syndrome is probably under-treated, not more common, and stress the need to watch for signs like social withdrawal rather than self-reported sadness.

The 1990 case shows rapid relief is possible; the 1996 follow-up warns it is not typical. Together they tell you to start medication when signs appear, monitor closely, and adjust if progress stalls.

If your client with Down syndrome stops enjoying favorite tasks, sleeps poorly, or withdraws, screen for depression and consult medical staff. Amitriptyline helped one person, but newer antidepressants with safer profiles are now first line. Track mood, sleep, and adaptive skills weekly so you can spot early relapse and prompt timely changes.