Researchers Warn: Common Antidepressant Should No Longer Be Used To Treat People With Dementia

Scientist Medicine Warning

A drug used to deal with agitation in individuals with dementia is not any more practical than a placebo, and may even enhance mortality, in keeping with a brand new research.

A drug used to deal with agitation in individuals with dementia is not any more practical than a placebo, and may even enhance mortality, in keeping with a brand new research.

The analysis, led by the College of Plymouth and printed in The Lancet, has proven that antidepressant mirtazapine provided no enchancment in agitation for individuals with dementia – and was presumably extra prone to be related to mortality than no intervention in any respect.  

Agitation is a typical symptom of dementia, characterised by inappropriate verbal, vocal or motor exercise, and infrequently includes bodily and verbal aggression. Non-drug patient-centered care is the primary intervention that must be provided however, when this doesn’t work, clinicians might transfer to a drug-based different. Antipsychotics have confirmed to extend loss of life charges in these with dementia, together with different poor outcomes, and so mirtazapine has been routinely prescribed. This research was designed so as to add to the proof base round its effectiveness.

Funded by the Nationwide Institute for Well being Analysis (NIHR), the research recruited 204 individuals with possible or attainable Alzheimer’s illness from 20 websites across the UK, allocating half to mirtazapine and half to placebo. The trial was double-blind; which means that neither the researcher nor the research individuals knew what they had been taking.

The outcomes confirmed that there was no much less agitation after 12 weeks within the mirtazapine group than within the management group. There have been additionally extra deaths within the mirtazapine group (seven) by week 16 than within the management group (just one), with evaluation suggesting this was of marginal statistical significance.

Lead researcher Professor Sube Banerjee, Govt Dean of the College of Well being and Professor in Dementia on the College of Plymouth, defined why the outcomes had been so stunning, however vital.

“Dementia impacts 46 million individuals worldwide – a determine set to double over the subsequent 20 years. Poor life high quality is pushed by issues like agitation and we have to discover methods to assist these affected,” he mentioned.

“This research exhibits {that a} frequent approach of managing signs just isn’t useful – and will even be detrimental. It’s actually vital that these outcomes are taken into consideration and mirtazapine is now not used to deal with agitation in individuals with dementia.

“This research has added vital data to the proof base, and we stay up for investigating additional therapies that will assist to enhance individuals’s high quality of life.”

Reference: “Research of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial” by Prof Sube Banerjee, MD; Juliet Excessive, MChem; Susan Stirling, MSc; Prof Lee Shepstone, PhD; Prof Ann Marie Swart, MSc; Tanya Telling, BSc; Catherine Henderson, PhD; Prof Clive Ballard, MD; Peter Bentham, MMedSci; Prof Alistair Burns, MD; Nicolas Farina, PhD; Prof Chris Fox, MD; Prof Paul Francis, PhD; Prof Robert Howard, MD; Prof Martin Knapp, PhD; Prof Iracema Leroi, MD; Prof Gill Livingston, MD; Prof Ramin Nilforooshan, MD; Shirley Nurock, MSc; Prof John O’Brien, DM; Annabel Worth, PhD; Prof Alan J Thomas, PhD and Naji Tabet, MD, 21 October 2021, The Lancet.
DOI: 10.1016/S0140-6736(21)01210-1

The research was co-authored by:

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