The Red-Light District

Exploring the carnal and taboo

Here's What Can Help With Agitation in Alzheimer’s

Helping agitation and caregiver distress in Alzheimer's.

Anybody who has a loved one with dementia and has assisted with her care knows how difficult the disease can be for everybody involved. Alzheimer’s disease is the most common form of dementia among the elderly with about 5.1 million Americans affected. The disease is progressive, slowly eroding memory and cognitive skills and eventually leaving a man with Alzheimer’s void of the ability to carry out even the simplest of tasks. It’s a terrible disease for which there is no cure and medications such as Namenda or Aricept offer little help.

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For anyone who has a loved one with Alzheimer’s disease, there’s always the hope that some intervention will alleviate some of the stress involved; stress which permeates the fabric of families and friendships. We’ve known for quite some time that antipsychotics offer no benefit to the patient with Alzheimer’s disease, but a new study shows that the SSRI citalopram (Celexa) can help with agitation.

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In the February 19, 2014, issue of JAMA, there’s a good journal article on the benefit of citalopram (Celexa) in patients with Alzheimer’s disease. During a nearly 4-year period, the 186 participants in the study were given either citalopram and psychotherapy or a placebo and psychotherapy. Researchers found that 40 percent of participants receiving citalopram had moderate or marked improvement compared with 26 percent who received the placebo. Furthermore, the administration of citalopram also reduced caregiver distress. Of note, distress in caregivers is very serious and can lead to psychological problems for the caregivers themselves. Researchers pointed out, however, that at higher doses, cardiac and cognitive adverse effects may limit the clinical utility of these findings.

I’ve been assigned articles on dementia and Alzheimer’s disease in the past, and every time I run across the topic, I feel much empathy for those involved. Over and over again, I speak with experts who reiterate how little can be done for patients with Alzheimer’s disease and how hard the disease is on loved ones. I know the stress that such disease can cause. It’s nice to see evidence that some drug may help with agitation and relieve some of the stress on caregivers. I hope that this finding results in clinical benefit.

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Naveed Saleh, M.D., M.S., attained a medical degree from Wayne State University School of Medicine and a master's degree in science journalism from Texas A&M.

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