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Medications for agitation in patients with Alzheimer disease include antidepressants, antipsychotics, and anticonvulsants, but all have limited efficacy. The selective serotonin reuptake inhibitor (SSRI) citalopram demonstrated efficacy in a 2014 trial but was associated with worsening cognition and cardiac conduction effects (NEJM JW Gen Med Mar 15 2014 and JAMA 2014; 311:682). Now, researchers have tested the efficacy and tolerability of escitalopram, the S-isomer of citalopram.
One hundred seventy-three patients with Alzheimer-related agitation who had undergone 3 weeks of psychosocial treatment without response were randomized to 12-week courses of daily escitalopram (15 mg) or placebo. At 12 weeks, the proportion of patients whose agita…