Little evidence that antidepressants help people with dementia

Photo credit: Buddhi Kumar Shurestha

According to Costello, Roiser and Howard (2023) there is a lack of scientific evidence showing any benefits of antidepressants for people with dementia (including Alzheimer’s disease). They arrived at this conclusion by reviewing all of the preceding research on the topic and evaluating the totality of the evidence. They found the evidence wanting. According to the research team, if currently available depression drugs do work on Alzheimer’s patients there is certainly no proof, and the effects can’t be large.

Here are their specific conclusions:

1. Anti-depressants developed for depression don’t work on dementia patients because their depression is structurally different/unrelated to regular depression.

2. There is currently no effective drug for reducing the symptoms of depression in dementia patients.

3. They also provide recommendations for how to develop a drug for depression in dementia patients. They emphasize developing it solely for that purpose and disregarding what works for non-dementia depression.

This very somber news comes on the heels of recent revelations that (a) what was thought to be the cause of Alzheimer’s disease (build up of amyloid proteins) is actually not the cause; cause still unknown, and (b) two amyloid reducing drugs recently approved by the FDA appear to be ineffective and harmful (Aducanumab and Lecanemab).