Antidepressant just as effective as antipsychotic in treating dementia

Sep 11 2007

Research in Canada has revealed that when it comes to treating the aggressive behaviour seen in people with Alzheimer's disease, antidepressants work just as well as a commonly prescribed antipsychotic medication but without the severe side-effects.

The study is the first to compare an antidepressant and an antipsychotic in patients who were not depressed.

The researchers at the Geriatric Mental Health Program at the Centre for Addiction and Mental Health (CAMH) say the findings suggest a new direction in drug treatment for psychotic disorders related to dementia in the elderly.

The researchers say they did not expect an antidepressant would have antipsychotic properties but also state that antipsychotics remain the first-line treatment for Alzheimer's-related psychosis and more studies are needed to confirm their findings.

The research team conducted a study on patients who had been hospitalized with psychiatric disturbances related to dementia; over the 12-week study period 53 patients were given the antidepressant citalopram and 50 received the antipsychotic risperidone.

It came as a surprise to the researchers to find that the two drugs were equally effective in reducing psychotic symptoms such as hallucinations, delusions, suspicious thoughts and agitation.

The agitation and psychotic symptoms are often more disturbing for both patients and families than the memory loss associated with Alzheimer's and other forms of dementia and also present the most difficult challenge for those caring for an elderly person.

Lead researcher Dr. Bruce Pollock, of the University of Toronto's Department of Psychiatry says they found that citalopram produced significantly fewer side effects, such as sedation, tension and apathy which can be very debilitating.

Dr. Pollock says some antipsychotics have been linked to early death when used to treat the psychosis that often comes with Alzheimer's disease; in 2005, both Health Canada and the U.S. Federal Drug Administration ordered manufacturers of risperidone and other "atypical antipsychotics" to put a "black box" warning on their products after they were found to increase the risk of early death in elderly patients.

The study is published in the online American Journal of Geriatric Psychiatry.