Antidepressants Are Ineffective for Depression in Dementia Patients

With no differences in effectiveness between antidepressants and placebo, psychosocial treatment approaches should be routinely pursued in the initial phase of treatment.

Depression worsens the course of dementia, but evidence for the effectiveness of antidepressants in patients with these illnesses is sparse and inconsistent. This large, randomized, controlled, 39-week treatment trial involved 326 patients with possible or probable Alzheimer disease, who were mostly community-dwelling and had sought care for depression at one of nine U.K. “old-age psychiatry services” (Cornell Scale for Depression in Dementia [CSDD] score, ≥8; mean score on the Mini-Mental State Exam, 18).

Treatments were sertraline, mirtazapine, or placebo; doses were increased at 4 and 8 weeks if CSDD scores did not decrease to below 4. Completion rates were 79% at 13 weeks (acute phase) and 69% at 39 weeks (mean doses among completers: se…

Reviewing Authors

Peter Roy-Byrne, MD

Disclosures

Editorial BoardsUpToDate

Peter Roy-Byrne, MD

Disclosures

Editorial BoardsUpToDate

Brandy R. Matthews, MD

Disclosures

Grant / Research supportNational Institute on Aging

Brandy R. Matthews, MD

Disclosures

Grant / Research supportNational Institute on Aging

Antidepressants Are Ineffective for Depression in Dementia Patients

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Reviewing Authors