What question did this study set out to answer?

To assess the efficacy and safety of antidepressants in treating agitation and psychosis in older adults diagnosed with Alzheimer's disease, vascular dementia, or mixed dementia.

February 4, 2011Cochrane libraryOpen Access

Antidepressants for agitation and psychosis in dementia

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Authors

DSDallas SeitzCentre for Addiction and Mental Health NANikesh AdunuriWestern University SGSudeep S. GillQueen's University

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Implication

Systematic review finds antidepressants reduce agitation in dementia, suggesting a potential alternative to antipsychotics.

Key Points

To assess the efficacy and safety of antidepressants in treating agitation and psychosis in older adults diagnosed with Alzheimer's disease, vascular dementia, or mixed dementia.
Systematic review and meta-analysis of randomized controlled trials identified across multiple databases through October 2009.
Included 9 trials examining 692 participants receiving antidepressants (SSRIs, trazodone, tricyclics) versus placebo or active comparators (typical or atypical antipsychotics).
Evaluated primary outcomes including dementia neuropsychiatric rating scales (such as the Cohen-Mansfield Agitation Inventory [CMAI] and Neurobehavioral Rating Scale [NBRS]) and adverse-event withdrawal rates.
SSRIs significantly improved CMAI total scores compared to placebo across two pooled studies (mean difference [MD] -0.89, 95% CI -1.22 to -0.57), although trials demonstrated no difference in adverse event-related withdrawals (relative risk [RR] 1.07, 95% CI 0.55 to 2.11).
Citalopram showed fewer side effects than risperidone on the UKU scale (MD -2.82, 95% CI -4.94 to -0.70), but no significant differences emerged between SSRIs and typical antipsychotics for CMAI scores (MD 4.66, 95% CI -3.58 to 12.90).
Trazodone showed no significant differences in CMAI total score changes compared to placebo (MD 5.18, 95% CI -2.86 to 13.22) or haloperidol (MD 3.28, 95% CI -3.28 to 9.85).

Cite This Study

Seitz et al. (2011) studied this question.

synapsesocial.com/papers/6a0043ceb124fe581985d010 https://doi.org/10.1002/14651858.cd008191.pub2

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Antidepressants for agitation and psychosis in dementia

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Cite This Study

Antidepressants for agitation and psychosis in dementia

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Implication

Key Points

Cite This Study

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