Can antidepressant medication relieve agitation in Alzheimer’s disease?

Abstract

Neuropsychiatric symptoms (NPS) are a major concern in the treatment of Alzheimer’s disease. Historically, NPS are difficult to treat effectively due to a high side-effect burden associated with commonly used medications, such as atypical antipsychotics. Non-pharmacological treatment approaches have become the first line option. However, when such treatment fails, pharmacological options are often used. Thus, a push toward finding safer alternative pharmacological treatments has occurred. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) have shown promise in clinical trials for alleviating the burden of NPS. Lower overall agitation and caregiver stress has been reported to correlate to treatment with the SSRI citalopram. However, certain side effects of citalopram, such as QTc interval prolongation and increased cognitive decline, carry clinical concern and should be weighed when prescribing their use.

Keywords::

• agitation
• Alzheimer’s disease
• antidepressants
• citalopram
• neuropsychiatric symptoms
• selective serotonin reuptake inhibitors
• treatment

Financial & competing interests disclosure

AP Porsteinsson reports receipt of a grant to his institution from Avanir, Baxter, BMS, Elan, EnVivo, Genentech/Roche, Janssen Alzheimer Initiative, Eli Lilly, Merck, Pfizer, Toyama, Medivation, the National Institutes of Health (NIH), the National Institute of Mental Health (NIMH), The National Institute on Aging (NIA), and the Department of Defense; paid consultancy for Elan, Janssen Alzheimer Initiative, Lundbeck, Pfizer, and TransTech Pharma; membership on data safety and monitoring boards for Quintiles, Functional Neuromodulation, and the New York State Psychiatric Institute; participation on a speaker’s bureau for Forest; and development of educational presentations for CME Inc. and PRI. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.