[Antidepressive agents in dementia].
Antidepressants are used in demented patients for treating depressive symptoms as well as other non-cognitive symptoms including agitation, aggression and irritability. As patients are usually elderly, a dose adjustment is mandatory for all classes of antidepressants. New antidepressants such as the SSRIs and the reversible MAO inhibitors should be the first-line agents in these patients, because their efficacy is not different from that of classic TCA, but they have advantages regarding frequency of adverse effects, ease of use and safety. Improvement in cognitive performance, however, may not be expected from the new antidepressants. For the treatment of agitation, aggression and irritability, antipychotics and benzodiazepines are in frequent use, although their adverse effects are particularly problematic in demented patients. Good alternatives are the antidepressant trazodone and citalopram. All medications mentioned have been studied on small patient samples, so treatment recommendations must be given cautiously.
Korthals Altes
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Klinik und Poliklinik für Psychiatrie und Psychotherapie Technische Universität München Ismaninger Strasse 22 D-81675 München.
Kurz
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D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D016896:Treatment Outcome
D000928:Antidepressive Agents