Kleptomania, a symptom of depression or frontotemporal dementia?

Three patients were presented in order to make differential diagnosis between affective disorder and dementia. All patients have diagnosis of affective disorder and they were in stable remission under antidepressive therapy. When pathological stealing occurred, there was a diagnostic dilemma: is it a new manifestation of affective disorder, rare side effect of serotonergic antidepressants or symptom of dementia. Neuroimaging methods, as well as neuropsychological testing identified that in these patients other symptoms of prefrontal dementia also existed. Frontotemporal dementia (FTD) is frequently misdiagnosed with depression, and so far, inadequately treated with higher doses of antidepressants. Such therapy could worsen clinical feature. These patients were successfully treated with combination of memantine and low doses of serotonergic antidepressants. In the future, multicentric investigation should be conducted to confirm effective therapeutic combination of psychopharmacs in cases of pathological stealing in FTD.