Antidepressant treatment in Alzheimer's disease

摘要

The negative results from the UK Health Technology Assessment (HTA) Study of the Use of Antidepressants for Depression in Dementia (SADD) trial reported by Sube Banerjee and colleagues in The Lancet are important for several reasons, not least because of the compelling size of the study. 326 participants with Alzheimer's disease and depression were randomly allocated to receive sertraline, mirtazapine, or placebo, making this landmark study the largest trial of antidepressant drugs in dementia ever and almost equalling the combined total from previously published work. Second, depression in dementia is very common, affecting around 20% of the 36 million people with dementia worldwide. Third, previous results of trials of antidepressants for depression in people with Alzheimer's disease have been unconvincing. The promise offered by the first Depression in Alzheimer Disease Study (DIADS) study, which reported benefit with sertraline, a selective serotonin reuptake inhibitor, was dashed by the negative findings at 12 or 24 weeks from the larger DIADS-2 trial.