Citalopram for agitation in Alzheimer's disease: Design and methods

Article (PDF Available)inAlzheimer's & dementia: the journal of the Alzheimer's Association 8(2):121-30 · February 2012with85 Reads
DOI: 10.1016/j.jalz.2011.01.007 · Source: PubMed
Agitation is one of the most common neuropsychiatric symptoms of Alzheimer's disease (AD), and is associated with serious adverse consequences for patients and caregivers. Evidence-supported treatment options for agitation are limited. The citalopram for agitation in Alzheimer's disease (CitAD) study was designed to evaluate the potential of citalopram to ameliorate these symptoms. CitAD is a randomized, double-masked, placebo-controlled multicenter clinical trial, with two parallel treatment groups assigned in a 1:1 ratio and randomization stratified by clinical center. The study included eight recruiting clinical centers, a chair's office, and a coordinating center located in university settings in the United States and Canada. A total of 200 individuals having probable AD with clinically significant agitation and without major depression were recruited for this study. Patients were randomized to receive citalopram (target dose of 30 mg/d) or matching placebo. Caregivers of patients in both treatment groups received a structured psychosocial therapy. Agitation was compared between treatment groups using the NeuroBehavioral Rating Scale and the AD Cooperative Study- Clinical Global Impression of Change, which are the primary outcomes. Functional performance, cognition, caregiver distress, and rates of adverse and serious adverse events were also measured. The authors believe the design elements in CitAD are important features to be included in trials assessing the safety and efficacy of psychotropic medications for clinically significant agitation in AD.

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Available from: Anton P Porsteinsson
    • "In addition to the early detection of neurodegenerative disease , the proposed MBI criteria may play a role in prevention. For example, in the Citalopram for Agitation in Alzheimer Disease trial, the effect of an antidepressant on agitation in nondepressed AD patients has been described [48,49]. Although effective for agitation and behavioral symptoms, citalopram was associated with slightly worsening cognition. "
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    • "Yet, the combination does not improve memory significantly but may have other benefits, compared with the group treated with rivastigmine alone [73, 74]. Similarly, sertraline and citalopram have shown a significant advantage in a subgroup of patients with moderate-to-severe behavioural and psychological symptoms of AD treated with donepezil [75][76][77]. Yet other studies have shown a lack of efficacy of sertraline in the treatment of depressive symptoms in patients with AD. "
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