title: Multicenter, randomized, placebo-controlled, double-blind clinical trial of escitalopram on the progression-delaying effects in Alzheimer's disease.
abstract: A series of preclinical studies have suggested that selective serotonin reuptake inhibitor antidepressants not only stimulate neurogenesis but also have neuroprotective effects. The present study primarily aimed to investigate whether escitalopram would decelerate the brain atrophy of patients with mild-to-moderate Alzheimer's disease (AD). We also assessed the effects of escitalopram on the cognitive function and neuropsychiatric symptoms of these participants.
  
  
  
  Seventy-four probable AD patients without major depression were recruited from four dementia clinics of university hospitals and randomly assigned in a 1:1 ratio. Each group received 20 mg/day of escitalopram or placebo for 52 weeks. The primary outcome measures were the change rates of hippocampal and whole brain volume on magnetic resonance imaging for 52 weeks. The Alzheimer's Disease Assessment Scale-cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory, and Cornell Scale for Depression in Dementia (CSDD) were also applied.
  
  
  
  We did not find any significant differences in the changes of hippocampal or whole brain volume between the groups. Escitalopram showed significant beneficial effects on the CSDD score at 28 weeks compared with placebo (t = -2.17, df = 50.42, p = 0.035), but this finding did not persist throughout the study.
  
  
  
  The findings of the present study do not support the role of escitalopram as a progression-delaying treatment for AD. However, the negative results of the present trial should be interpreted cautiously because of the relatively small sample size. Further large-scale escitalopram trials targeting the earlier stages of AD, even prodromal AD, are still needed. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Neuropsychiatry, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Choe
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Kangwon National University Hospital, Chunchon, Korea.
authors.forename: Jin Hyeong
authors.initials: JH
authors.lastname: Jhoo
authors.affiliation: Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Ryu
authors.affiliation: Division of Natural Medical Sciences, College of Health Science Chosun University, Gwangju, Korea.
authors.forename: Eun Hyun
authors.initials: EH
authors.lastname: Seo
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Bo Kyung
authors.initials: BK
authors.lastname: Sohn
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Byun
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jae-Hwa
authors.initials: JH
authors.lastname: Bak
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
authors.forename: Hyuk Jin
authors.initials: HJ
authors.lastname: Yun
authors.affiliation: Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea.
authors.forename: Myeong-Il
authors.initials: MI
authors.lastname: Han
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jong Inn
authors.initials: JI
authors.lastname: Woo
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Young
authors.initials: DY
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D015283:Citalopram / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006624:Hippocampus / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D018696:Neuroprotective Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Alzheimer's disease; brain atrophy; clinical trial; escitalopram; magnetic resonance imaging; selective serotonin reuptake inhibitor