Explaining HD irritability, depression, suicide risk, and tetrabenazine to a spouse — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar. Neurology remains involved. You meet the spouse alone first.^[1]

Candidate instructions. Explain that mood and irritability are common, treatable parts of HD — not simple moral failure. Explain elevated suicide risk and why safety matters. Explain that tetrabenazine can help chorea but may worsen mood, so doses are reviewed jointly. Explain stepped treatment (support, SSRI, cautious antipsychotic if needed) without promising paralysis from 'schizophrenia doses.' Decline secret testing of the asymptomatic child and explain ethics gently. Agree a shared plan that does not stop all neurology medicines abruptly. Avoid inventing legal section numbers.^[2][3][4][5]