title: Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram.
abstract: BACKGROUND
  This study examined the potential of an antidepressant drug, escitalopram, to improve depression, resilience to stress, and quality of life in family dementia caregivers in a randomized placebo-controlled double-blinded trial.
  
  
  METHODS
  Forty family caregivers (43-91 years of age, 25 children and 15 spouses; 26 women) who were taking care of their relatives with Alzheimer disease were randomized to receive either escitalopram 10 mg/day or placebo for 12 weeks. Severity of depression, resilience, burden, distress, quality of life, and severity of care-recipient's cognitive and behavioral disturbances were assessed at baseline and over the course of the study. The Hamilton Depression Rating Scale scores at baseline ranged between 10 and 28. The groups were stratified by the diagnosis of major and minor depression.
  
  
  RESULTS
  Most outcomes favored escitalopram over placebo. The severity of depression improved, and the remission rate was greater with the drug compared with placebo. Measures of anxiety, resilience, burden, and distress improved on escitalopram compared with placebo.
  
  
  CONCLUSIONS
  Among caregivers, this small randomized controlled trial found that escitalopram use resulted in improvement in depression, resilience, burden and distress, and quality of life. Our results need to be confirmed in a larger sample.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA 90095, USA. hlavrets@ucla.edu
authors.forename: Helen
authors.initials: H
authors.lastname: Lavretsky
authors.forename: Prabha
authors.initials: P
authors.lastname: Siddarth
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy; D017028:Caregivers / Q000523:psychology*; D015283:Citalopram / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010919:Placebos; D011788:Quality of Life; D012074:Remission Induction; D055500:Resilience, Psychological / Q000187:drug effects*; D013315:Stress, Psychological / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D010919:Placebos; D015283:Citalopram