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[Antidepressive agents in dementia].

M Korthals Altes1, A Kurz

  • 1Klinik und Poliklinik für Psychiatrie und Psychotherapie Technische Universität München Ismaninger Strasse 22 D-81675 München.

Zeitschrift Fur Gerontologie Und Geriatrie
|December 29, 2000
PubMed
Summary

Antidepressants can manage depression and behavioral issues in dementia patients. Newer agents like SSRIs and MAO inhibitors are preferred due to better safety and ease of use, though cognitive improvements are not expected.

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Area of Science:

  • Geriatric Psychiatry
  • Pharmacology
  • Neuroscience

Context:

  • Dementia patients often experience depressive and behavioral symptoms like agitation and aggression.
  • Elderly patients require careful dose adjustments for all psychotropic medications.
  • Traditional treatments for agitation, such as antipsychotics and benzodiazepines, pose significant risks in dementia.

Purpose:

  • To review the use of antidepressants for managing depressive and non-cognitive symptoms in patients with dementia.
  • To compare the efficacy, safety, and tolerability of different antidepressant classes in this population.
  • To identify safer alternatives for managing agitation, aggression, and irritability in demented individuals.

Summary:

  • Selective Serotonin Reuptake Inhibitors (SSRIs) and reversible Monoamine Oxidase Inhibitors (MAOIs) are recommended as first-line treatments for depressive and behavioral symptoms in dementia.
  • These newer antidepressants offer comparable efficacy to classic Tricyclic Antidepressants (TCAs) but with a better safety profile and fewer adverse effects.
  • Trazodone and citalopram are highlighted as effective alternatives for managing agitation, aggression, and irritability, with fewer risks than antipsychotics or benzodiazepines.
  • Cognitive improvement should not be anticipated with these antidepressant therapies.
  • Treatment recommendations are based on small studies and should be applied cautiously.

Impact:

  • Provides guidance for clinicians on selecting appropriate antidepressant pharmacotherapy for dementia patients.
  • Highlights safer medication options for managing challenging behavioral symptoms in dementia.
  • Emphasizes the need for cautious interpretation of findings due to limited sample sizes in existing research.

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