TY - JOUR
T1 - Sertraline for the treatment of depression in alzheimer disease
T2 - Week-24 outcomes
AU - Weintraub, Daniel
AU - Rosenberg, Paul B.
AU - Drye, Lea A
AU - Martin, Barbara K.
AU - Frangakis, Constantine
AU - Mintzer, Jacobo E.
AU - Porsteinsson, Anton P.
AU - Schneider, Lon S.
AU - Rabins, Peter V.
AU - Munro, Cynthia A.
AU - Meinert, Curtis L.
AU - Lyketsos, Constantine G.
N1 - Funding Information:
This work was supported by the National Institute of Mental Health , 1U01MH066136 , 1U01MH068014 , 1U01MH066174 , 1U01MH066175 , 1U01MH066176 , and 1U01MH066177 .
Funding Information:
Barbara K. Martin is involved in another trial for which Pfizer donated a different drug; Paul B. Rosenberg has received research funds from Pfizer, Elan, Lilly and Merck in amounts greater than $10,000; Jacobo Mintzer has received research support from Abbott to study donepezil and divalproex sodium, from AstraZeneca to study quetiapine, from BMS to study aripiprazole, from Eli Lilly to study olanzapine, from Forest to study both citalopram and memantine, from Janssen to study galantamine and risperidone, and from Pfizer to study donepezil and memantine; Dr. Mintzer also has been a consultant, paid directly or indirectly, for AstraZeneca, BMS, Eli Lilly, Janssen, Pfizer, Forest, and Aventis. He also has been an unpaid consultant for Targacept and has participated in Speaker's Bureaus for Janssen, Forest, and Pfizer; Daniel Weintraub has received research support from Boehringer Ingelheim; Dr. Weintraub also has been a paid consultant for Acadia Pharmaceuticals, Novartis Pharmaceuticals, Boehringer Ingelheim, Osmotica Pharmaceutical, BrainCells Inc., Merck Serono, and Sanofi Aventis, and has participated on a Speaker's Bureau for Pfizer; Anton P. Porsteinsson is involved in research sponsored by Pfizer to study donepezil and PF04494700, Eli Lilly to study atomoxetine, a gamma-secretase inhibitor and a beta amyloid antibody, Wyeth to study a beta amyloid antibody, GSK to study a PPAR-gamma agonist inhibitor and Forest to study memantine and neramexane; Dr. Porsteinsson has been a paid consultant and participated on a Speaker's Bureau for Pfizer and Forest; Lon S. Schneider is involved in research sponsored by Pfizer; Dr. Schneider has been a paid consultant for Forest, GlaxoSmithKline, Lilly, Merck, and Wyeth; Constantine Frangakis has no conflict of interests; Lea T. Drye has no conflict of interests; Peter V. Rabins has participated on Speaker's Bureaus for Wyeth, Eli Lilly, and Pfizer and has received reimbursement for legal testimony from Janssen Pharmaceutica. Cynthia A. Munro has no conflict of interests; Curtis L. Meinert is involved in another trial for which Pfizer donated a different drug; Dr. Meinert owns shares of GSK stock; Constantine G. Lyketsos was involved in another trial for which Pfizer donated a different drug; he also was involved in research sponsored by Forest to study escitalopram and citalopram and Pfizer to study sertraline and donepezil; and Dr. Lyketsos served as a consultant for Organon, Eisai, GSK, Lilly, Wyeth, and Pfizer.
PY - 2010/4
Y1 - 2010/4
N2 - BACKGROUND: Depression and antidepressant use are common in Alzheimer disease (AD), but the effect of antidepressant treatment for depression on longer term outcomes is unknown. The authors report the Week-24 outcomes of patients who participated in a 12-week efficacy study of sertraline for depression of AD. METHODS: One hundred thirty-one participants (sertraline = 67, placebo = 64) with mild-moderate AD and depression participated in the study. Patients who showed improvement on the modified Alzheimer's Disease Cooperative Study Clinical Global Impression-Change (mADCS-CGIC) after 12 weeks of randomized treatment with sertraline or placebo continued double-blinded treatment for an additional 12 weeks. Depression response and remission at 24 weeks were based on mADCS-CGIC score and change in Cornell Scale for Depression in Dementia (CSDD) score. Secondary outcome measures included time to remission, nonmood neuropsychiatric symptoms, global cognition, function, and quality of life. RESULTS: One hundred seventeen (89.3%) participants completed all study assessments and 74 (56.5%; sertraline = 38, placebo = 36) completed all 24 weeks on randomized treatment. By 24 weeks, there were no between-group differences in depression response (sertraline = 44.8%, placebo = 35.9%; odds ratio [95% CI] = 1.23 [0.64-2.35]), change in CSDD score (median difference = 0.6 [95% CI:-2.26 to 3.46], χ [df = 2] = 1.03), remission rates (sertraline = 32.8%, placebo = 21.8%; odds ratio [95% CI] = 1.61 [0.70-3.68]), or secondary outcomes. Common selective serotonin reuptake inhibitor-associated adverse events, specifically diarrhea, dizziness, and dry mouth, and pulmonary serious adverse events were more frequent in sertraline-randomized patients than in placebo subjects. CONCLUSIONS: Sertraline treatment is not associated with delayed improvement between 12 and 24 weeks of treatment and may not be indicated for the treatment of depression of AD.
AB - BACKGROUND: Depression and antidepressant use are common in Alzheimer disease (AD), but the effect of antidepressant treatment for depression on longer term outcomes is unknown. The authors report the Week-24 outcomes of patients who participated in a 12-week efficacy study of sertraline for depression of AD. METHODS: One hundred thirty-one participants (sertraline = 67, placebo = 64) with mild-moderate AD and depression participated in the study. Patients who showed improvement on the modified Alzheimer's Disease Cooperative Study Clinical Global Impression-Change (mADCS-CGIC) after 12 weeks of randomized treatment with sertraline or placebo continued double-blinded treatment for an additional 12 weeks. Depression response and remission at 24 weeks were based on mADCS-CGIC score and change in Cornell Scale for Depression in Dementia (CSDD) score. Secondary outcome measures included time to remission, nonmood neuropsychiatric symptoms, global cognition, function, and quality of life. RESULTS: One hundred seventeen (89.3%) participants completed all study assessments and 74 (56.5%; sertraline = 38, placebo = 36) completed all 24 weeks on randomized treatment. By 24 weeks, there were no between-group differences in depression response (sertraline = 44.8%, placebo = 35.9%; odds ratio [95% CI] = 1.23 [0.64-2.35]), change in CSDD score (median difference = 0.6 [95% CI:-2.26 to 3.46], χ [df = 2] = 1.03), remission rates (sertraline = 32.8%, placebo = 21.8%; odds ratio [95% CI] = 1.61 [0.70-3.68]), or secondary outcomes. Common selective serotonin reuptake inhibitor-associated adverse events, specifically diarrhea, dizziness, and dry mouth, and pulmonary serious adverse events were more frequent in sertraline-randomized patients than in placebo subjects. CONCLUSIONS: Sertraline treatment is not associated with delayed improvement between 12 and 24 weeks of treatment and may not be indicated for the treatment of depression of AD.
KW - Alzheimer disease
KW - Depression
KW - Sertraline
UR - http://www.scopus.com/inward/record.url?scp=77949511377&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949511377&partnerID=8YFLogxK
U2 - 10.1097/JGP.0b013e3181cc0333
DO - 10.1097/JGP.0b013e3181cc0333
M3 - Article
C2 - 20220589
AN - SCOPUS:77949511377
VL - 18
SP - 332
EP - 340
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 4
ER -