Effect of a Serotonin Reuptake Inhibitor on Irritability, Apathy, and Psychotic Symptoms in Patients With Alzheimer's Disease

Objective: To ascertain the impact of treatment with citalopram on irritability, apathy, delusions, and hallucinations in nondepressed behaviorally disturbed Alzheimer’s disease (AD) patients.

Method: This was a retrospective analysis of data from the 36-week Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer’s Disease in which patients with probableAD (diagnosed according to criteria of the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association [NINCDS/ADRDA]) were treated in a naturalistic manner. Scores were compared on the irritability, apathy, delusions, and hallucinations subscales of the Neuropsychiatric Inventory. The trial was conducted between April 2001 and November 2004.

Results: Of the 421 patients enrolled, 44 were started on placebo and were later randomly assigned to citalopram treatment. There were data available for 34 subjects who took placebo for at least 14 days. In this group, there was a 60% reduction in irritability and apathy scores, no effect on scores for delusions, and a clinically insignificant drop in scores for hallucinations.

Conclusion: The use of citalopram was associated with greatly reduced irritability without sedation in a group of behaviorally disturbed patients with AD.