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

Haroon Siddique, MD; Linda S. Hynan, PhD; and Myron F. Weiner, MD

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 probable AD (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.


(J Clin Psychiatry 2009;70(6):915-918. Online Ahead of Print May 5, 2009. doi:10.4088/JCP.08m04828)

Received October 27, 2008; accepted February 24, 2009. From the Departments of Psychiatry (all authors), Clinical Sciences, Division of Biostatistics (Dr Hynan), and Neurology (Dr Weiner), University of Texas Southwestern Medical Center, Dallas.

This study was supported by a grant from the National Institutes of Health and the National Institute on Aging (5 P30 AG012300 to Dr Hynan).

The authors report no additional financial or other relationships relevant to the subject of this article.

Corresponding author and reprints: Myron F. Weiner, MD, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9129