| Objective This study is to observe the efficacy and security of Citalopram in the treatment of behavioural and psychological symptoms of dementia(BPSD)and cognitive function induced by Alzheimer disease(AD).Key secondary objective examine effects of citalopram on caregiver distress.Methods From April 2015 to February 2015 in Qingdao Mental Health Center,80 cases of moderate Alzheimer's disease(according to the clinical dementia rating scale,CDR)with symptoms of BPSD were collected and were randomly divided into treatment group and control group,40 cases in each group.Treatment group was given Citalopram(10 to30 mg/d)treatment.The dose of citalopram began at 10 mg per day with planned titration to 30 mg per day over 2 weeks based on response and tolerability.Control group was given the same dose of placebo.Both groups were given Memantine(10 mg/bid)for 12 weeks of treatment.Simple mental state examination(MMSE)was used to measure cognitive function impairment.Neural psychiatric questionnaire(NPI)measurement was examed to BPSD and caregiver distress.Blood routine,urine routine,biochemical,electrocardiogram and electroencephalogram were done for each patient every month routinely to check the change induced by using medication.The symptoms scale(TESS)assessed adverse effects.Results 1.After treatment for 12 weeks,participants of treatment group showed statistically significant reduction of agitation/aggression,apathy,dysthymia and anxiety scores compared with control group(P< 0.05).In treatment group,the rates of decreases were higher in agitation/aggression(40.80%,),dysthymia(30.89%,)and anxiety(35.27%.)scores after the treatment.2.The reducing rate that was abviously changed in control group was agitation/aggression,which was 30.34%,while it was still lower than treatment group(30.34%<40.80%).3.Participants of treatment group showed statistically significant reduction of caregiver stress and total NPI scores compared with control group(P<0.05).No other symptoms improved significantly(P > 0.05).4.Participants of treatment group showed statistically significant reduction of MMSE scores compared with control group(P<0.05).5.TESS scale did not see obvious difference between two groups(P>0.05).In the control group,there were two patients who complained dry mouth and one patient showed increased libido who withdraw from the study.In treatment group,QTc interval prolongation were seen in two participants who treated by 30 mg citalopram per day.One of them withdraw from the study.Discontinuations due to adverse events were similar in the two groups.Conclusion 1.Compared with Menantine,Citalopram combined with Memantine can significant effectively reduce agitation,apathy,dysthymia and anxiety symptoms in the patients with moderate Alzheimer's disease,especially agitation,dysthymia and anxiety symptoms,and agitation is in the most.2.Citalopram combined with Memantine can more effectively reduce caregiver distress and total NPI scores.But the overall clinical curative effect is likely to be limited.Although it can change four clinical symptoms mentioned above,the change of the other eight clinical symptoms of NPI is not obvious.That is the reason why the total NPI scores reducing rate is not high.3.Citalopram combined Menation can more effectively improve cognitive function.4.Citalopram applied in Alzheimer's patients is safe and effective..Meaning Citalopram has shown potential efficacy in adjunctive therapy of AD patients with BPSD. |
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