title: Is sertraline treatment or depression remission in depressed Alzheimer patients associated with improved caregiver well being? Depression in Alzheimer's Disease Study 2.
abstract: OBJECTIVE
  We wanted to assess if sertraline treatment (versus placebo) or remission of depression at 12 weeks (versus nonremission) in Alzheimer patients is associated with improved caregiver well being.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of sertraline for the treatment of depression in individuals with Alzheimer disease in five clinical research sites across the United States. Participants were caregivers of patients enrolled in the Depression in Alzheimer's Disease Study 2 (N = 131). All caregivers received standardized psychosocial support throughout the study. Caregiver outcome measures included depression (Beck Depression Inventory), distress (Neuropsychiatric Inventory), burden (Zarit Burden Interview), and quality of life (Medical Outcomes Study Short Form Health Survey).
  
  
  RESULTS
  Fifty-nine percent of caregivers were spouses, 63.4% were women, and 64.1% were white. Caregivers of patients in both treatment groups had significant reductions in distress scores over the 24-week study period, but there was not a greater benefit for caregivers of patients taking sertraline. However, caregivers of patients whose depression was in remission at week 12 had greater declines in distress scores over the 24 weeks than caregivers of patients whose depression did not remit by week 12.
  
  
  CONCLUSIONS
  Patient treatment with sertraline was not associated with significantly greater reductions in caregiver distress than placebo treatment. Distress but not level of depression or burden lessened for all caregivers regardless of remission status and even more so for those who cared for patients whose depression remitted. Results imply an interrelationship between caregiver distress and patient psychiatric outcomes.
authors: Medical University of South Carolina, Department of Neurosciences, Charleston, SC. Electronic address: crystalflynn@hotmail.com.
authors: Crystal V
authors: CV
authors: Flynn Longmire
authors: Lea T
authors: LT
authors: Drye
authors: Constantine E
authors: CE
authors: Frangakis
authors: Barbara K
authors: BK
authors: Martin
authors: Curtis L
authors: CL
authors: Meinert
authors: Jacobo E
authors: JE
authors: Mintzer
authors: Cynthia A
authors: CA
authors: Munro
authors: Anton P
authors: AP
authors: Porsteinsson
authors: Peter V
authors: PV
authors: Rabins
authors: Paul B
authors: PB
authors: Rosenberg
authors: Lon S
authors: LS
authors: Schneider
authors: Daniel
authors: D
authors: Weintraub
authors: Constantine G
authors: CG
authors: Lyketsos
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000451:nursing* / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000150:complications / Q000188:drug therapy* / Q000451:nursing; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012075:Remission, Spontaneous; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use*; D013315:Stress, Psychological
chemical_list: D020280:Sertraline
keywords: Alzheimer disease; DIADS-2; Sertraline; caregivers; depression