Antidepressants for treating depression in dementia.

Area of Science:

• Geriatric Psychiatry
• Clinical Pharmacology

Background:

• Widespread use of antidepressants for dementia with depression.
• Uncertainty regarding clinical efficacy and limited precision from small trials.

Purpose of the Study:

• To determine antidepressant effectiveness and acceptability in dementia patients with depression.

Main Methods:

• Systematic review and meta-analysis of double-blind, randomized trials.
• Searched major health databases and contacted pharmaceutical companies.
• Included studies compared antidepressants with placebo in dementia and depression patients.

Main Results:

• Seven studies (1140 subjects) were included; four (137 subjects) entered meta-analysis.
• Selective serotonin reuptake inhibitors (SSRIs) were investigated in only two studies.
• Meta-analysis showed a significant difference favoring placebo for adverse events; limited efficacy found.

Conclusions:

• Available evidence offers weak support for antidepressant efficacy in dementia with depression.
• Paucity of research, small sample sizes, and limited investigation of common antidepressants (SSRIs) and newer classes.
• Highlights the need for more robust research in this area.