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Alzheimer's Disease Health Center

Celexa May Help Ease Alzheimer's-Linked Agitation

Study finds it might be safer alternative to standard antipsychotics
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WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

TUESDAY, Feb. 18, 2014 (HealthDay News) -- The antidepressant Celexa shows promise in easing the agitation people with Alzheimer's disease often suffer, and may offer a safer alternative to antipsychotic drugs, a new study finds.

"Agitation is one of the worst symptoms for patients and their families: it puts the Alzheimer's patient at risk for other system overloads (cardiac, infection), wears them out physically, and exhausts caregivers and families," noted one expert, Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City.

He said that while antipsychotic drugs are typically used to help ease the agitation, they are also associated with a higher risk of death for Alzheimer's patients, so safer alternatives would be welcome.

The new study was led by Dr. Constantine Lyketsos, director of the Johns Hopkins Memory and Alzheimer's Treatment Center in Baltimore. It included 186 Alzheimer's patients with agitation symptoms such as emotional distress, aggression, irritability, and excessive movement.

For nine weeks, about half the patients took increasing doses of the antidepressant drug citalopram, which is sold under the brand names Celexa and Cipramil and also as generics. The dose peaked at 30 milligrams a day. The rest of the patients took an inactive placebo.

Patients taking the drug showed a significant decline in their agitation symptoms and their caregivers reported less stress. In one measure of agitation, about 40 percent of patients taking the antidepressant had "considerable relief," compared with 26 percent of those who took the placebo.

But the drug had risks, too. According to the study, patients taking the antidepressant were more likely to have slightly decreased mental function and abnormal heart function that increases the risk of heart attack.

But antipsychotic medications -- which are currently the first-line treatment for agitation in Alzheimer's patients -- also increase the risk of heart attack, perhaps even more so than citalopram, Lyketsos noted.

Antipsychotic drugs also significantly increase the risk of stroke and death. In lower doses than those used in the study, citalopram might be safer than antipsychotic drugs, the researchers concluded.

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