Antidepressant Celexa could be an alternative to antipsychotic medication for Alzheimer's, study suggests

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An antidepressant drug could help relieve agitation symptoms of Alzheimer's disease, reducing reliance on antipsychotic medications, according to recently published study results.

Researchers from a variety of institutions, including the Johns Hopkins University and Columbia University, took part in the Citalopram for Agitation in Alzheimer's Disease Study (CitAD). Citalopram is an antidepressant sold as Celexa and Cipramil.

The study involved 186 Alzheimer's patients. One group received up to 30 milligrams of citalopram per day for nine weeks, while another group received a placebo. The antidepressant led to “significant relief” of agitation, the researchers found. By one measure, 40% of patients on citalopram had “considerable relief,” compared to 26% of patients on the placebo.

Behavioral interventions had failed for all the participants, and antipsychotic drugs also failed in some cases. However, behavioral approaches remain the preferred treatment for agitation, emphasized researcher Bruce G. Pollock, M.D., Ph.D., vice president of research at the Centre for Addiction and Mental Health in Canada.

There may be adverse cognitive effects associated with citalopram, the researchers acknowledged. However, when behavioral interventions are not effective, citalopram could offer a better alternative than antipsychotics.

"Antipsychotics are not an ideal therapy and significantly increase the risk of strokes, heart attacks and sudden death," Pollock said.

Long-term care providers have systematically been working to reduce antipsychotic prescribing, and have been drawing closer to goals set through high-profile initiatives.

The CitAD findings appear in the Journal of the American Medical Association.

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