TUESDAY, July 19 (HealthDay News) -- The antidepressants most
often prescribed to treat depression in dementia patients provide
no appreciable relief, and may raise the risk for serious side
effects, new British research suggests.
"The two classes of antidepressants most likely to be prescribed for depression in Alzheimer's disease are no more effective than placebo," the study authors said.
The drugs in question are Zoloft (sertraline), and Remeron
(mirtazapine).
"In our study, there were more adverse reactions in individuals treated with antidepressants than there were with placebo," the research team added. "Clinicians and investigators need to reframe the way they think about the treatment of people with Alzheimer's disease who are depressed, and reconsider routine prescription of antidepressants."
Led by Sube Banerjee of the Institute of Psychiatry at Kings
College London in England, the authors reported their findings
online July 19 in
The Lancet.
Banerjee and his colleagues focused on 325 patients being
treated at any of nine health centers across England for probable
or possible Alzheimer's disease. The patients were also subject to
bouts of depression lasting at least a month, and all registered
above a minimum threshold during dementia-related depression
exams.
None had been prescribed antidepressants prior to the study
launch, nor were any in a critical stage of depression involving
suicidal thoughts.
The patients were divided into three 13-week treatment groups.
One group received 150 milligrams (mg) a day of sertraline; a
second group received 45 mg a day of mirtazapine; and a third took
sugar pills (placebos).
After three months, the authors found no difference in the
incidence of depression among the three groups. The lack of an
apparent benefit attributable to either sertraline or mirtazapine
continued almost 10 months after the study's start, according to a
journal news release.
Also, while about a quarter of those given placebos experienced
adverse reactions as a result of treatment, that figure rose to
between 41 percent and 43 percent in the groups given an
antidepressant. Such side effects were also more likely to be
serious among the antidepressant recipients than among the placebo
group.
Dr. Henry Brodaty, an aging and dementia specialist at the
University of New South Wales in Sydney, Australia, and author of
an accompanying journal editorial, said the trial "has underscored
the need for clinicians to think about creative alternatives to
drug treatment for management of depression in people with
dementia." It is important to use evidence-based techniques and to
work in partnership with family caregivers, he wrote in the news
release.
More information
For more on dementia and depression, visit the
Alzheimer's Society.