[A version of this abstract appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 1 Issue 9, April 2011].
Psychosis and agitation occur commonly in older adults with dementia. Medications prescribed to treat these symptoms increasingly include antidepressants. This systematic review examines evidence for the effectiveness and safety of antidepressants for the treatment of agitation and psychosis in older adults with dementia. Antidepressants are categorised according to the mechanism of their action and various studies comparing use of antidepressants to treatment with either a placebo (no treatment) or other medications frequently used are reviewed. Nine studies (including 692 individuals) have been identified in total, but most of these were relatively small and had an uncertain risk of bias.
The Selective Serotonin Re-uptake Inhibitors (SSRIs) sertraline and citalopram appear to be associated with a modest reduction in symptoms of agitation and psychosis. The authors conclude that the use of certain antidepressants for agitation and psychosis in dementia is justifiable, but they caution that further studies are required to determine the effectiveness and safety of SSRIs and trazodone for the management of these symptoms.
Seitz, DP. Adunuri, N. Gill, SS. [et al] (2011). Antidepressants for agitation and psychosis in dementia. Cochrane Database of Systematic Reviews, February 16th 2011 Issue No.2, No.CD008191.