A Randomized Double-Blind Placebo-Controlled Trial of Combined Escitalopram and Memantine for Older Adults With Major Depression and Subjective Memory Complaints.
Am J Geriatr Psychiatry
; 28(2): 178-190, 2020 02.
Article
in En
| MEDLINE
| ID: mdl-31519517
ABSTRACT
OBJECTIVE:
Geriatric depression is difficult to treat and frequently accompanied by cognitive complaints that increase risk for dementia. New treatment strategies targeting both depression and cognition are urgently needed.METHODS:
We conducted a 6-month double-blind placebo-controlled trial to assess the efficacy and tolerability of escitalopramâ¯+â¯memantine (ESC/MEM) compared to escitalopramâ¯+â¯placebo (ESC/PBO) for improving mood and cognitive functioning in depressed older adults with subjective memory complaints (NCT01902004). Primary outcome was change in depression as assessed by the HAM-D post-treatment (at 6 months). Remission was defined as HAM-D ≤6; naturalistic follow-up continued until 12 months.RESULTS:
Of the 95 randomized participants, 62 completed the 6-month assessment. Dropout and tolerability did not differ between groups. Mean daily escitalopram dose was 11.1 mg (SDâ¯=â¯3.7; range 5-20 mg). Mean daily memantine dose was 19.3 mg (SDâ¯=â¯2.6; range 10-20 mg). Remission rate within ESC/MEM was 45.8% and 47.9%, compared to 38.3% and 31.9% in ESC/PBO, at 3 and 6 months, respectively (χ2(1)â¯=â¯2.0, pâ¯=â¯0.15). Both groups improved significantly on the HAM-D at 3, 6, and 12 months, with no observed between-group differences. ESC/MEM demonstrated greater improvement in delayed recall (F(2,82)â¯=â¯4.3, p = 0.02) and executive functioning (F(2,82)â¯=â¯5.1, p = 0.01) at 12 months compared to ESC/PBO.CONCLUSIONS:
The combination of memantine with escitalopram was well tolerated and as effective as escitalopram and placebo in improving depression using HAM-D. Combination memantine and escitalopram was significantly more effective than escitalopram and placebo in improving cognitive outcomes at 12 months. Future reports will address the role of biomarkers of aging in treatment response.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Citalopram
/
Memantine
/
Selective Serotonin Reuptake Inhibitors
/
Depressive Disorder, Major
/
Memory
Type of study:
Clinical_trials
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Am J Geriatr Psychiatry
Journal subject:
GERIATRIA
/
PSIQUIATRIA
Year:
2020
Type:
Article