Gender, aggression and serotonergic function are associated with response to sertraline for behavioral disturbances in Alzheimer's disease.
BACKGROUND
Indications for serotonergic medications in the treatment of behavioral disorders associated with Alzheimer's disease (AD) remain to be established.


METHODS
Sertraline (100 mg OD) was evaluated in a double-blind, randomized, placebo-controlled cross-over study in 22 nondepressed patients with severe probable AD and significant behavioral disturbance. Each subject was given a fenfluramine challenge to evaluate central serotonergic tone.


RESULTS
Eight of 21 (38%) completers responded to sertraline. Drug responsive behaviors included aggression/agitation, irritability and aberrant motor behavior. Low aggression, female gender and large prolactin increase were associated with a better response. There was a trend for decreased aggression during sertraline versus placebo (p = 0.08).


CONCLUSIONS
Aggression, gender and serotonergic function were associated with sertraline response. Larger randomized controlled trials are needed to clarify the profile of responders.
Psychopharmacology Research Program and Geriatric Psychiatry, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, 207s Bayview Avenue, Toronto, Ontario M4N 3M5, Canada. krista.lanctot@swchsc.on.ca
Krista L
KL
Lanctôt
Nathan
N
Herrmann
Robert
R
van Reekum
Goran
G
Eryavec
Claudio A
CA
Naranjo
D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011985:Receptors, Serotonin / Q000187:drug effects / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D020280:Sertraline / Q000494:pharmacology*; D012737:Sex Factors; D016896:Treatment Outcome
D011985:Receptors, Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline