Antidepressant Treatment for Depression in Alzheimerandrsquo;s Dementia: Systematic Review Article

Abstract

Introduction: Alzheimer's Dementia (AD) is a neurodegenerative disease characterized by progressive cognitive decline. Neuropsychiatric symptoms (NPS) are frequently described in AD. Among the non-cognitive symptoms that can occur in AD, depression is the most common one. Objective: The aim was to review published studies in order to examine the efficacy and safety of antidepressant medication for depression in AD. Methods: An electronic database search was performed using the keywords: ” antidepressant ” , “ randomized controlled trial (RCT)”, “depression”, “dementia”, ”Alzheimer’s disease”. For the evaluation of efficacy, the reduction of scores on the evaluation scales of depression and the rate of response or remission were used and for the safety evaluation the rate of dropout and the rate of adverse effects were considered. The effect of antidepressant therapy on cognitive performances was also tracked. Results: According to inclusion criteria, 14 RCT studies that aimed at assessing the efficacy and safety of an antidepressant in the treatment of AD associated depression have been selected, as well as 6 additional studies that use two or more antidepressants. The results show a debatable efficacy of these treatments. Among the included antidepressants, selective serotonin reuptake inhibitors (SSRIs) have proven to be most tolerated and without negative effects on cognition. Conclusions: The available evidence does not provide sufficient support to uphold the efficacy and safety of antidepressant in the treatment of AD associated depression