Born with a silver spoon in his mouth, he now uses it for heroin

Benedict Cumberbatch plays privileged but miserable uppercrust addict Patrick Melrose

Patrick Melrose (Sky Atlantic, Sunday, 9pm) lives a life of extremely privileged, self-medicated misery – a man born with a silver spoon in his mouth, now using it to cook up his heroin.

When we first see him, this paragon of upper-crust London, in a new series based on Edward St Aubyn’s caustic series of novels (themselves based very squarely on St Aubyn’s life), Patrick is told about the death of his father, by telephone, and seems to crumple at the news. But, retrieving an intravenous needle from the floor, while barely hearing details of his father’s exclusive mortuary in New York (“Only the best go there”), a smile slips across his face and he drifts into a scornful kind of reverie. This, we soon understand, is Melrose’s place.

Played by Benedict Cumberbatch as an elegant and vulnerable creature, like a collapsing giraffe, Patrick is the hero of a show that is at once escapist and punishing. "You're hardly the rehab type," counsels one of his lovers. "You're too upholstered." Cumberbatch gives Patrick perfect posture and a constant film of sweat, as though trying to compensate for the loosening effects of any number of intoxicants.

The comedy of the show is not just this outrageous dissolution – at one point literally squeaking down the marble walls of a hotel lobby slightly bigger than Grand Central Station when his cocktail of quaaludes, speed and martinis kick in – but how the upper strata of wealth in 1980s New York prevents anyone from commenting on the situation.

For that, though, Patrick has himself. His mind roils with ceaseless commentary, jumbled up with literary quotation (“The sun shone, having no alternative, on the nothing new.” “My heart is a handful of dust.”), buffeted between his own mordant thoughts and punctuated by several intruding voices.

In moments of drug-induced delirium or panicky withdrawal, Patrick answers back to his own voice-over: “Still, at least it’s the last time,” his mind offers in a fug of paranoid and suicidal thoughts. “Or among the last times,” his spoken voice counters.

At times, that can recall the warring private and public voices of Peep Show (or, given the high theatricality of Cumberbatch's monologues, even Philadelphia, Here I Come), but Melrose's head is more cramped.

You can understand his mild hysteria when a waiter asks if anyone will be joining him. “Fucking hell,” he trills, “I hope not.” Sometimes even one is a crowd.

If it is hard to sympathise with Patrick’s luxurious self-obliteration it isn’t so much because his wealth makes him seem so far removed – forever fanning dollars out of a thick envelope, tucking his syringes into a pocket square, or idly praising the reliability of Concorde – but because there’s little sense of what else, or who else, Patrick could even be.

Directed with verve and panache by Edward Berger, the show makes it mortifyingly apparent that he is wasted, but what potential or ambition has he wasted? (In St Aubyn's books, it's clear, Patrick's alternative is to be St Aubyn, to make mordant and successful art of his tangled experience.)

Here, with the violations of his sexually abusive father (Hugo Weaving), and the wilful blindness of his absent mother (Jennifer Jason Leigh) nudging continually at his memories, the source of Patrick’s trauma is made abundantly clear. But, too upholstered for therapy, neither the path of recovery, nor even a destination, is so obvious.

To see Cumberbatch in a familiar state of cerebral agitation, with the collar of his great coat pulled up high, even he doesn't seem sure what lies beneath this debauchery, unless it is the possibility that Patrick might pull his life together enough to one day become Sherlock Holmes (and that's really saying something).

But the most affecting moment comes at the episode’s end, when, restating his intentions to go clean, Patrick is asked, “What are you going to do instead?” He has no answer, no voice.

And finally he crumples; this time for real.