Sertraline improves quality of life and lessens disruption in daily activities for Alzheimer's patients who have major depression despite a lack of effect on cognitive abilities, according to an article in the July issue of the Archives of General Psychiatry.

"Depression in Alzheimer's patients, and even Alzheimer's disease itself, often goes undiagnosed, in part because doctors feel they have little to offer in the form of treatment. This study shows that a simple treatment for depression improves the quality of life and seems to slow the functional decline of Alzheimer's disease," said Constantine Lyketsos, M.D., lead author of the study.

Major depression affects 25 percent of patients with Alzheimer's disease. When combined with cognitive impairment, it can be extremely disabling and can lead to suicide or spontaneous death, noted Lyketsos.

"This simple and safe treatment for depression has tremendous potential for improving the quality of life for both Alzheimer's patients and their caregivers," he added.

The current study enrolled adults with both Alzheimer's disease and major depression. All patients and their caregivers were educated about the two disorders and received encouragement and emotional support throughout the study. All patients were rated on a standardized depression scale and given a single placebo pill daily for 1 week in order to identify participants with transient or temporary depression. Patients who had a drop of 30 percent or more in their depression scores after the placebo phase were excluded from the study.

The 44 eligible patients were randomized to placebo or sertraline (mean dose, 95 mg/day) once daily for 12 weeks. Patients were seen in the clinic every 3 weeks for 12 weeks following the end of the treatment period.

The researchers found that 84 percent of people who received the drug showed some degree of improvement compared with 35 percent in the placebo group. The researchers found that treating depression not only improved the symptoms of depression, but also produced a lower level of behavioral disturbance and improved abilities to attend to activities of daily living.

Based on the results, Lyketsos and his American colleagues are leading a multicenter clinical trial to investigate the long-term benefits of sertraline for patients with Alzheimer's disease and to determine any benefits for the participants’ caregivers.