: A 2014 randomized trial found that citalopram provided a modest improvement in neuropsychiatric symptoms; however the dose used was 30mg/day, which has since been discouraged by the FDA. These are the drugs FDA-approved to treat the memory and thinking problems associated with Alzheimer’s disease.
Otherwise clinical studies find that antidepressants are not effective for reducing agitation. In some patients they seem to help with certain neuropsychiatric symptoms.
For this reason, in 2013 the American Geriatrics Society made the following recommendation as part of its Choosing Wisely campaign: “Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia.” You may now be wondering what should be the first choice.This depends on the situation, but generally, the first choice to treat difficult behaviors is NOT medication.(A possible exception: geriatricians do often consider medication to treat pain or constipation, as these are common triggers for difficult behavior.) Instead, medications should be used after non-drug management approaches have been tried, or at least in combination with non-drug approaches.For more on the names of these drugs and how they work, see 4 Medications to Treat Alzheimer’s & Other Dementias.Note: I am not including medications to manage dementia-related sleep disturbances in this post.