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    An 85-year-old man with advanced dementia presents to your office accompanied by his daughter. She is upset because he has been increasingly agitated and combative in the evenings. You wonder if antidepressants can improve his symptoms. There are few high-quality studies examining the effectiveness of antidepressants for treating the neuropsychiatric symptoms of dementia. Although there is some evidence to support the use of the selective serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft) and citalopram (Celexa), they should be used only if nonpharmacologic interventions are unsuccessful. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.) Agitation and psychosis are common among older adults with dementia and are challenging to manage. At the present time, little is known about the effectiveness and safety of antidepressant medications when used to treat these symptoms. We searched the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register, which included Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), Medline (January 1950 to October 2009), EMBASE (1980 to October 2009), CINAHL (all dates to October 2009), and Psyc INFO (1806 to October 2009). Two types of drugs you may want to avoid for the sake of your brain. Alternative drugs to antipsychotics Alzheimer's Society Antidepressants for Agitation and Psychosis in Patients with Dementia.
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