Antidepressant may help in dementia, researchers find

Researchers also found that the antidepressant was associated with “significantly lower” adverse side effects. The study, funded by the National Institutes of Health and published in the online American Journal of Geriatric Psychiatry, is believed to be the first head-to-head comparison of an selective serotonin reuptake inhibitor (SSRI) with one of the more commonly prescribed second-generation antipsychotics in older, non-depressed patients.

In this 12-week clinical trial, 53 patients were given daily doses of citalopram and 50 received daily doses of Risperdal (risperidone). Overall, 43% of the participants completed the trial: 47% in the citalopram group and 40% in the risperidone group. The dropout rate is typical for this vulnerable population, according to Dr Pollock, and does not undermine the scientific validity of the findings.

The researchers were surprised to find that citalopram and risperidone had similar efficacy in reducing psychosis (hallucinations, delusions, suspicious thoughts) and agitation. Overall, there was a 32% reduction of symptoms with citalopram and a 35% reduction with risperidone. Citalopram was associated with a significantly lower burden of adverse side effects, such as sedation, tension and apathy. Total side effect burden scores increased 19% for risperidone and decreased by 4% with citalopram.

Although the findings raise the possibility of a new direction in drug treatment for psychotic disorders related to dementia in the elderly, the researchers caution that more studies are needed.