With Monitoring, Dementia Patients Could Discontinue Antidepressants

FEATURED SEARCH TERM:   on the efficacy of psychiatric drugs


Antidepressants “could be discontinued in most patients with dementia”, according to the first randomized trial to test the question, but patients should be monitored carefully for worsening depressive symptoms. Although in this trial most dementia patients with neuropsychiatric symptoms who discontinued taking a selective serotonin reuptake inhibitor (SSRI) had a significant increase in depressive symptoms at 25 weeks (as against a slight reduction in symptoms among those who continued medication), the vast majority (86%) were able to tolerate going off the medication.


RESULT: Discontinuation of antidepressants in people with dementia and neuropsychiatric symptoms (DESEP study): double blind, randomised, parallel group, placebo controlled trial
British Medical Journal | Mar 20, 2012 (FREE FULL TEXT)



The scope of this problem is quite large; some 80% of nursing home patients with Alzheimer’s disease develop neuropsychiatric symptoms. Before using an atypical antipsychotic, these authors suggest considering non-pharmacological interventions, such as cognitive stimulation and behavioral management paradigms, or a trial with an SSRI for those with mild to moderate symptoms.


RESULT: Antipsychotics for Behavioral Disturbance in Dementia? A Clinical Conundrum
Psychiatric Times | Feb 28, 2012 (FREE FULL TEXT)