Efficacy of SSRIs on cognition of Alzheimer's disease patients treated with cholinesterase inhibitors.
BACKGROUND
This study examines the joint effect on cognition of selective serotonin re-uptake inhibitors (SSRIs) and cholinesterase inhibitors (AChEIs) in depressed patients affected by Alzheimer's disease (AD) living at home.


METHODS
The study was conducted in two different outpatient neurological clinics. 338 patients with probable AD were treated with ChEis (donepezil, rivastigmine and galantamine) as per the clinician's judgment and were observed for nine months. At study entry, participants underwent a multidimensional assessment evaluating cognitive, functional and psychobehavioral domains. All patients were evaluated at baseline, after one (T1), three (T2) and nine months (T3). Patients were grouped in three different categories (patients not depressed and not treated with SSRIs, patients depressed and treated with SSRIs, and patients depressed but not treated with SSRIs).


RESULTS
At baseline 182 were diagnosed as not depressed and not treated with SSRIs, 66 as depressed and treated with SSRIs, and 90 as depressed but not treated with SSRIs. The mean change in MMSE score from baseline to nine months showed that depressed patients not treated worsened in comparison with those not depressed and not treated with SSRIs (mean change -0.8 +/- 2.3 vs 0.04 +/- 2.9; p = 0.02) and patients depressed and treated with SSRI (mean change -0.8 +/- 2.3 vs 0.1 +/- 2.5; p = 0.03).


CONCLUSIONS
In AD patients treated with AChEIs, SSRIs may exert some degree of protection against the negative effects of depression on cognition.
Rozzini
Luca
L
Department of Neurology, University of Brescia, Brescia, Italy. Email: lrozzini@iol.it
Chilovi
Barbara Vicini
BV
Conti
Marta
M
Bertoletti
Erik
E
Zanetti
Marina
M
Trabucchi
Marco
M
Padovani
Alessandro
A
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005473:Fluoxetine / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D009483:Neuropsychological Tests; D017374:Paroxetine / Q000494:pharmacology / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D012720:Severity of Illness Index
D002800:Cholinesterase Inhibitors; D015283:Citalopram; D005473:Fluoxetine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors