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We report a 78-year-old man with treatment-refractory depressive and anxiety symptoms accompanied by paroxysmal somatic attacks, unresponsive to psychotropic treatment and modified electroconvulsive therapy. Ultimately, biomarker evaluation confirmed AD pathology, and donanemab was initiated. Follow-up amyloid positron emission tomography demonstrated marked amyloid clearance, particularly in the frontal lobe, accompanied by concurrent improvement in depressive symptoms, cognition, and reduced somatic attacks. 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