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Recent open-label trials of antidepressant treatments for dementia, as well as meta-analyses of placebo-controlled trials of tricyclic antidepressants, suggest that these drugs have limited efficacy. Controlled studies are warranted, but treatment options are limited. To determine the effectiveness of citalopram, sertraline, and imipramine in AD. Eighty-eight AD patients were randomly assigned to citalopram (N = 30), sertraline (N = 29), or imipramine (N = 29) in a double-blind placebo-controlled 8-week trial. Measures included the MMSE, Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog), Clinical Global Impressions (CGI), Clinical Dementia Rating (CDR), and the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL). Citalopram and imipramine improved the patient's condition slightly, but significantly more than placebo; sertraline showed no significant differences. In the placebo group, 56% deteriorated on the MMSE over 8 weeks, whereas only 33% of those assigned to citalopram and 25% of those assigned to sertraline deteriorated. Likewise, 71% of placebo patients became agitated or confused, whereas only 10% of those assigned to citalopram and 33% of those assigned to sertraline became so. Patients assigned to citalopram showed significantly improved performance on the ADAS-cog, although there was no significant improvement on the ADCS-ADL. The effects of citalopram were dose-related. Citalopram may have a slight positive effect on cognitive functions in patients with AD.Mental health needs of older adults in Assam and West Bengal, India.
Older persons constitute a rapidly growing proportion of the Indian population, and these people are likely to be mentally disabled as well. There are no published data on the mental health problems of older people in India. This study examined the prevalence of major mental illnesses, including depression and dementia, among older people in Assam and West Bengal using a sub-sample of data collected for a larger study on elderly cognitive ability. Data were collected from 1568 persons aged
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