Moclobemide in Elderly Patients with Cognitive Decline and Depression: An International Double-blind, Placebo-controlled Trial

Roth, Martin; Mountjoy, C.Q.; Amrein, R.

doi:10.1192/bjp.168.2.149

Cited by 166 publications

(86 citation statements)

References 30 publications

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“…However, it is notable that significant declines in cognition were measured in the 2 studies involving TCAs, 43,44 and thus caution is advised when prescribing this class of medication to those with dementia. Raw data were not obtainable for one positive study of moclobemide that involved a substantial number of subjects 40 ; although this omission is unfortunate, moclobemide is not available in the United States and is used relatively infrequently in Canada. Newer antidepressant medications, including bupropion, mirtazapine, and venlafaxine, could also not be included in the current metaanalysis because of a lack of published RCTs on this population.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Antidepressants for Treatment of Depression in Alzheimer's Disease: A Metaanalysis

Thompson¹,

et al. 2007

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Objective: Depression in patients with Alzheimer's disease (AD) is common (15% to 63%) and is associated with significant morbidity and increased mortality. Our objective was to quantitatively summarize the data on the efficacy and safety of antidepressant treatment for depression complicating AD. Method:We performed a metaanalysis of randomized, double-blind, placebo-controlled trials of antidepressants with a database search of the English literature (up to 2006) and a manual search of references in the retrieved articles. We extracted the proportion of subjects who responded and remitted, experienced adverse events (AEs), discontinued treatment due to AEs, or discontinued treatment for any reason. Cognition scores were also extracted. Results:We included 5 studies, which involved 82 subjects treated with antidepressants and 83 subjects who received placebo treatment. Antidepressants were superior to placebo for both treatment response (odds ratio [OR] 2.32; 95% confidence interval [CI], 1.04 to 5.16) and remission of depression (OR 2.75; 95%CI, 1.13 to 6.65). There were no significant differences between the 2 groups for change in cognition (weighted mean difference -0.71, 95%CI, -3.20 to 1.79), overall dropouts (OR 0.70; 95%CI, 0.29 to 1.66) or dropout due to AEs (OR 1.41; 95%CI 0.36 to 5.54). The numbers needed to treat for one additional AD patient to respond to antidepressant treatment were 5 (95%CI, 3 to 59) and 5 (95%CI, 2 to 24) for remission of depression. Conclusions:Antidepressant treatment for depression in AD is efficacious, with rates of discontinuation that are comparable to placebo. Nonetheless, clinicians must be vigilant regarding the potential side effects of antidepressants in this population. Clinical Implications· Antidepressants are efficacious in the treatment of depression in AD. · Tolerability of antidepressants in AD appears to be similar to placebo. · TCAs may be associated with a decline in cognition. Limitations· Antidepressant classes were not compared because of the limited number of published trials in AD. · Individual AEs could not be analyzed. · Individual trials were limited by small sample sizes, low medication dosages, differing outcomes of interest, and varying outcomes measures.

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Section: Discussionmentioning

confidence: 99%

“…40 Raw study data were requested from several studies' authors and sites and (or) drug manufacturers [38][39][40] ; however, this information was not received. Two studies were not included 41,42 because they were head-to-head studies that…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Antidepressants for Treatment of Depression in Alzheimer's Disease: A Metaanalysis

Thompson¹,

et al. 2007

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“…The efficacy of antidepressant treatment for depression in AD has been assessed in a limited number of placebo-controlled efficacy studies of antidepressants from several different classes [Reifler et al, 1989;Nyth et al, 1990Nyth et al, , 1992Petracca et al, 1996;Roth et al, 1996;Magai et al 2000;Petracca et al 2001;Lyketsos et al 2000aLyketsos et al , 2003]. These studies evaluated antidepressants from most classes available to clinicians, and no drug-or class-specific patterns are obvious.…”

Section: Treatment Of Depression In Admentioning

confidence: 99%

Diagnosis and Treatment of Depression in Alzheimer’s Disease

Lyketsos

Lee

2003

Dement Geriatr Cogn Disord

124

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Over 80% of patients with Alzheimer’s disease (AD) develop ‘noncognitive’ neuropsychiatric symptoms at some point during the course of their illness. Depression is among the most frequent of such comorbidities. Affecting up to 50% of AD patients, depression is associated with severe negative consequences for patients and caregivers. Despite having a presentation in the context of AD that differs from typical ‘geriatric’ depression, it can be detected and quantified reliably, and can be differentiated from the other neuropsychiatric symptoms of AD. Several effective treatment modalities for depression in AD are available. In many cases, these reduce its adverse impact on patients and caregivers. This paper provides an overview of current knowledge regarding depression in AD for the clinician. It is followed by a practical discussion of the detection, evaluation, quantification, differential diagnosis and treatment of depression in AD.

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“…There have not been any randomized, controlled trials of mirtazapine, escitalopram, venlafaxine (e19), reboxetine, or duloxetine; these drugs can be given on an individual trial basis. Trazodone (33) and MAO inhibitors (34) have been found effective in a small number of studies. Trazodone improves anxiety (33); its risks are sedation, hypertensive crisis, and priapism.…”

Section: Table 1bmentioning

confidence: 99%

The Diagnosis and Treatment of Behavioral Disorders in Dementia

Kratz¹

2017

Deutsches Ärzteblatt International

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Moclobemide in Elderly Patients with Cognitive Decline and Depression: An International Double-blind, Placebo-controlled Trial

Abstract: Moclobemide was shown to be a safe, well tolerated and effective antidepressant, which did not cause impairment of cognitive function in elderly patients with a DSM-III diagnosis of dementia and/or DSM-III major depression.

Cited by 166 publications

References 30 publications

Efficacy and Safety of Antidepressants for Treatment of Depression in Alzheimer's Disease: A Metaanalysis

Efficacy and Safety of Antidepressants for Treatment of Depression in Alzheimer's Disease: A Metaanalysis

Diagnosis and Treatment of Depression in Alzheimer’s Disease

The Diagnosis and Treatment of Behavioral Disorders in Dementia

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