Effects of Citalopram on Neuropsychiatric Symptoms in Alzheimer’s Dementia: Evidence From the CitAD Study

Leonpacher, Anne K.; Peters, Matthew E.; Drye, Lea T.; Makino, Kelly M.; Newell, Jeffery; Devanand, Devangere P.; Frangakis, Constantine; Munro, Cynthia A.; Mintzer, Jacobo; Pollock, Bruce G.; Rosenberg, Paul B.; Schneider, Lon S.; Shade, David M.; Weintraub, Daniel; Yesavage, Jerome A.; Lyketsos, Constantine G.; Porsteinsson, Anton P.

doi:10.1176/appi.ajp.2016.15020248

Cited by 76 publications

(44 citation statements)

References 35 publications

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“…In a randomized, double blind, placebo-control study, the effects of citalopram on psychiatric and behavioral symptoms in Alzheimer’s disease was evaluated. The study concluded that there was a significant decrease in anxiety symptoms after 9 weeks of citalopram use when compared with placebo [24]. An open-label trial examined the impact of citalopram on anxiety symptoms, when Parkinson's disease patients are treated for depression.…”

Section: Serotonin Specific Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

Pharmacological Management of Anxiety Disorders in the Elderly

Crocco

Jaramillo

Cruz-Ortiz

et al. 2017

Curr Treat Options Psych

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Opinion Statement Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction. Those antidepressants with more favorable pharmacokinetic profiles should be considered first-line in the treatment of anxiety. Mirtazapine and vortioxetine are also considered safe treatment options. Buspirone may have benefit, but lacks studies in elderly populations. Although tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be effective in the elderly, their side effect and safety profiles are suboptimal and thus are not recommended in late-life. Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term. In addition, antipsychotics have a black box warning for increased mortality in elderly patients with dementia.

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Section: Serotonin Specific Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

Pharmacological Management of Anxiety Disorders in the Elderly

Crocco

Jaramillo

Cruz-Ortiz

et al. 2017

Curr Treat Options Psych

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“…Non‐pharmacological treatment has been found to be effective and is generally recommended as the first‐line approach . Pharmacological therapy, including antipsychotics, cholinesterase inhibitors, and antidepressants, have all been reported to have favourable effects on NPS, including when delusions or psychoses are studied as individual target symptoms . Certain profiles of NPS have been found to predict behavioural responsiveness to donepezil, including the presence of delusions …”

Section: Introductionmentioning

confidence: 99%

“…11 Pharmacological therapy, including antipsychotics, cholinesterase inhibitors, and antidepressants, have all been reported to have favourable effects on NPS, including when delusions or psychoses are studied as individual target symptoms. [12][13][14][15] Certain profiles of NPS have been found to predict behavioural responsiveness to donepezil, including the presence of delusions. 16 Few systematic reviews or meta-analyses exist to inform health care professionals on the prevalence of individual NPS in AD.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of delusions in drug‐naïve Alzheimer disease patients: A meta‐analysis

Lai

Lee

Chan

et al. 2017

Int J Geriat Psychiatry

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This meta-analysis calculates a 29.1% prevalence rate of delusions in AD patients. There is a trend towards increasing delusion prevalence in concordance with increasing severity of dementia. Given delusions are associated with poorer outcomes, the obtained prevalence should motivate clinicians to screen carefully for delusions. Current literature limitations warrant future studies, with sub-analyses on dementia severity, and other neurobiological factors known to influence the presence of delusions.

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“…Citalopram is an effective and well-tolerated treatment for elderly depressed patients with or without dementia [ 26 ]. In AD patients, citalopram improved behavioral symptoms, such as agitation and irritability [ 27 , 28 ]. Also, citalopram can decrease A β production in mice and humans [ 8 , 9 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Citalopram Ameliorates Impairments in Spatial Memory and Synaptic Plasticity in Female 3xTgAD Mice

Zhang

Guo

Niu

et al. 2017

BioMed Research International

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Alzheimer's disease (AD) is the primary cause of dementia. There is no effective treatment. Amyloid-β peptide (Aβ) plays an important role in the pathogenesis and thus strategies suppressing Aβ production and accumulation seem promising. Citalopram is an antidepressant drug and can decrease Aβ production and amyloid plaques in transgenic mice of AD and humans. Whether citalopram can ameliorate memory deficit was not known yet. We tested the effects of citalopram on behavioral performance and synaptic plasticity in female 3xTgAD mice, a well-characterized model of AD. Mice were treated with citalopram or water from 5 months of age for 3 months. Citalopram treatment at approximately 10 mg/kg/day significantly improved spatial memory in the Morris water maze (MWM) test, while not affecting anxiety-like and depression-like behavior in 3xTgAD mice. Further, hippocampal long-term potentiation (LTP) impairment in 3xTgAD mice was reversed by citalopram treatment. Citalopram treatment also significantly decreased the levels of insoluble Aβ40 in hippocampal and cortical tissues in 3xTgAD mice, accompanied with a reduced amyloid precursor protein (APP). Together, citalopram treatment may be a promising strategy for AD and further clinical trials should be conducted to verify the effect of citalopram on cognition in patients with AD or mild cognitive impairment.

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Effects of Citalopram on Neuropsychiatric Symptoms in Alzheimer’s Dementia: Evidence From the CitAD Study

Cited by 76 publications

References 35 publications

Pharmacological Management of Anxiety Disorders in the Elderly

Pharmacological Management of Anxiety Disorders in the Elderly

Prevalence of delusions in drug‐naïve Alzheimer disease patients: A meta‐analysis

Citalopram Ameliorates Impairments in Spatial Memory and Synaptic Plasticity in Female 3xTgAD Mice

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