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MS – Depression Management — SCE Neurology MCQ

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EasyMultiple Sclerosis & CNS InflammationMS – Depression ManagementSCE Neurology

A 58-year-old man with MS has severe fatigue, low mood, and cognitive impairment. His neurologist suspects depression contributing to his symptoms. What is the recommended approach to managing depression in MS per NICE guidance?

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Correct answer: A — Treat as per standard depression guidelines (NICE CG90/NG222) — offer psychological therapy and/or antidepressant medication

NICE NG100 recommends that depression in MS should be recognised and treated actively, following the same principles as for depression in the general population (NICE CG90/NG222). This includes offering psychological therapies (CBT, counselling) and/or antidepressant medication (SSRIs as first-line). Depression is common in MS (~50% lifetime prevalence) and significantly impacts quality of life, fatigue, and cognitive function. It may be under-recognised and under-treated. A: Depression requires active treatment. C: Steroids do not treat depression and may worsen it. D: DMTs do not treat depression. E: ECT is not first-line for depression.

Reference: NICE NG100 MS (2022); NICE CG90 Depression (2009)