Effect of a serotonin reuptake inhibitor on irritability, apathy, and psychotic symptoms in patients with Alzheimer's disease.
OBJECTIVE
To ascertain the impact of treatment with citalopram on irritability, apathy, delusions, and hallucinations in nondepressed behaviorally disturbed Alzheimer's disease (AD) patients.


METHODS
This was a retrospective analysis of data from the 36-week Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease in which patients with probable AD (diagnosed according to criteria of the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association [NINCDS/ADRDA]) were treated in a naturalistic manner. Scores were compared on the irritability, apathy, delusions, and hallucinations subscales of the Neuropsychiatric Inventory. The trial was conducted between April 2001 and November 2004.


RESULTS
Of the 421 patients enrolled, 44 were started on placebo and were later randomly assigned to citalopram treatment. There were data available for 34 subjects who took placebo for at least 14 days. In this group, there was a 60% reduction in irritability and apathy scores, no effect on scores for delusions, and a clinically insignificant drop in scores for hallucinations.


CONCLUSIONS
The use of citalopram was associated with greatly reduced irritability without sedation in a group of behaviorally disturbed patients with AD.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9129, USA.
Haroon
H
Siddique
Linda S
LS
Hynan
Myron F
MF
Weiner
D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003702:Delusions / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D004359:Drug Therapy, Combination; D006212:Hallucinations / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects*; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D009042:Motivation; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors