Watch out for antidepressants used against dementia. Agitation is common in older people with dementia and seriously affects their quality of life. To cure it, patient-centered non-drug care is the first line of treatment, but other treatments are sometimes necessary when such care is not effective. Medicines can thus constitute an alternative, and this is particularly the case of antidepressants. Problem, a study published on October 23 in the journal The Lancet for’to assess the efficacy and safety of mirtazapine, an antidepressant prescribed for agitation in dementia. While current evidence is scarce on safer and more effective alternatives to antipsychotics, researchers at Plymouth University in England have shown that this noradrenergic antidepressant and specific serotonergic not only offered no improvement in agitation, but was mainly associated with a increased mortality compared to a total absence of drug intervention.
7 deaths in the group who took mirtazapine
In practice, researchers have recruited 204 people possibly suffering from Alzheimer’s disease and gave half the mirtazapine and the other half a placebo. The trial was double-blind, which meant that neither the researcher nor the participants knew what they were taking. The results showed that there was no reduction in agitation after 12 weeks of prescription and there had been seven deaths in the group prescribed mirtazapine in week 16 of the trial, compared with only one death in the control group in the same week. Principal investigator Professor Sube Banerjee, executive dean of the Faculty of Health and professor of dementia at the University of Plymouth, explained that the “most common way to manage symptoms of dementia is not helpful and could even be detrimental “. “It is really important that these results are taken into account and that mirtazapine should no longer be used to treat agitation in people with dementia“, assures the researcher.
Professor Sube Banerjee recalls that “dementia affects 46 million people worldwide, a figure that is expected to double over the next 20 years. ”As a reminder, agitation is a common symptom of dementia, characterized by inappropriate verbal, vocal or motor activity, and often involves physical and verbal aggression. lead author of the study, “Poor quality of life is caused by issues like restlessness and we need to find ways to help those affected.” “This study added important information to the database evidence, and we look forward to exploring other treatments that could help improve people’s quality of life, ”he concludes.
Sertraline does not reduce symptoms any more than placebo
According to Dr Patrick Lemoine, psychiatrist and doctor in neuroscience, whose comments have been reported by Medisite, many studies have shown the ineffectiveness of antidepressants in the treatment of mild to moderate depression. An earlier study published in September 2019 in The Lancet Psychiatry had demonstrated that sertraline (Zoloft®) did not reduce symptoms of depression any more than placebo, although it was more effective in treating anxiety. “In fact, every time you look at the studies – whether it’s Prozac®, Effexor® and others like Zoloft® – when you’re in a register of mild to moderate depression, you don’t find difference with the placebo, or almost “, recalls the doctor. “Two thirds of Prozac studies are negative, it should not be forgotten”.