Citalopram for the Treatment of Agitation in Alzheimer Dementia

Matthew E. Peters, Vijay Vaidya, Lea T. Drye, Davangere P. Devanand, Jacobo E. Mintzer, Bruce G. Pollock, Anton P. Porsteinsson, Paul B. Rosenberg, Lon S. Schneider, David M. Shade, Daniel Weintraub, Jerome Yesavage, Constantine G. Lyketsos, Dimitri Avramopoulos

Research output: Contribution to journalArticle

Abstract

Objective: To assess potential genetic influences on citalopram treatment efficacy for agitation in individuals with Alzheimer dementia (AD). Six functional genetic variants were studied in the following genes: serotonin receptor 2A (HTR2A-T102C), serotonin receptor 2C (HTR2C-Cys23Ser), serotonin transporter (5HTT-LPR), brain-derived neurotropic factor (BDNF-Val66Met), apolipoprotein E (∈2, ∈3, ∈4 variants), and cytochrome P450 (CYP2C19). Treatment response by genotype was measured by (1) the agitation domain of the Neurobehavioral Rating Scale, (2) the modified Alzheimer Disease Cooperative Study - Clinical Global Impression of Change scale (mADCS-CGIC), (3) the agitation domain of the Neuropsychiatric Inventory (NPI), and (4) the Cohen-Mansfield Agitation Inventory. Method: We utilized data from the Citalopram for Agitation in Alzheimer's Disease (CitAD) database. CitAD was a 9-week randomized, double-blind, placebo-controlled multicenter clinical trial showing significant improvement in agitation and caregiver distress in patients treated with citalopram. Proportional odds logistic regression and mixed effects models were used to examine the above-mentioned outcome measures. Results: Significant interactions were noted on the NPI agitation domain for HTR2A (likelihood ratio [LR] = 6.19, df = 2, P =.04) and the mADCS-CGIC for HTR2C (LR = 4.33, df = 2, P =.02) over 9 weeks. Discussion: Treatment outcomes in CitAD showed modest, although statistically significant, influence of genetic variation at HTR2A and HTR2C loci. Future studies should continue to examine the interaction of known genetic variants with antidepressant treatment in patients with AD having agitation.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalJournal of Geriatric Psychiatry and Neurology
Volume29
Issue number2
DOIs
StatePublished - Mar 1 2016

Keywords

  • Alzheimer disease
  • agitation
  • antidepressant
  • citalopram
  • dementia
  • genetics
  • randomized trial

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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  • Cite this

    Peters, M. E., Vaidya, V., Drye, L. T., Devanand, D. P., Mintzer, J. E., Pollock, B. G., Porsteinsson, A. P., Rosenberg, P. B., Schneider, L. S., Shade, D. M., Weintraub, D., Yesavage, J., Lyketsos, C. G., & Avramopoulos, D. (2016). Citalopram for the Treatment of Agitation in Alzheimer Dementia. Journal of Geriatric Psychiatry and Neurology, 29(2), 59-64. https://doi.org/10.1177/0891988715601735