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
en 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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Citalopram
/
Memantina
/
Inhibidores Selectivos de la Recaptación de Serotonina
/
Trastorno Depresivo Mayor
/
Memoria
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Am J Geriatr Psychiatry
Asunto de la revista:
GERIATRIA
/
PSIQUIATRIA
Año:
2020
Tipo del documento:
Article