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Treatment for depression comorbid with dementia

Lookup NU author(s): Dr Jennifer Burgess, Dr Charlotte Allan


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© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.Depression is a common comorbidity in dementia. Randomised controlled studies of antidepressants do not show a significant improvement in depressive symptoms in patients with comorbid dementia and are known to lead to an increase in side effects. However, there are relatively few studies of depression in dementia, and drawing firm conclusions about the use of antidepressants is limited by the amount of data available. Furthermore, it is unclear whether data can be extrapolated from similar populations (eg, those with late-life depression) to inform pharmacotherapy in this patient group. Given the lack of effectiveness and risk of side effects associated with pharmacological treatments, psychological interventions may offer important therapeutic benefits. There is evidence for the effectiveness of individual psychological therapy, and further research will establish which psychological approach is the most effective. Some studies have shown an improvement in depressive symptoms using structured sleep hygiene programmes, exercise, arts interventions and music therapy. These studies are hampered by small data sets, and the benefits to individuals may not be well captured by standard outcome measures. At present, the best evidence for arts-based approaches is in music therapy. Depression with comorbid dementia responds well to electroconvulsive therapy and this is a useful treatment modality for those with severe or life-threatening depressive symptoms. Alternative neurostimulation techniques such as transcranial magnetic stimulation are not widely used at present and further research is needed before they can be a more widely used treatment modality.

Publication metadata

Author(s): Baruch N, Burgess J, Pillai M, Allan CL

Publication type: Review

Publication status: Published

Journal: Evidence-Based Mental Health

Year: 2019

Volume: 22

Issue: 4

Pages: 167-171

Print publication date: 23/10/2019

Online publication date: 26/09/2019

Acceptance date: 11/09/2019

ISSN (print): 2040-4050

ISSN (electronic): 1557-6272

Publisher: BMJ Publishing Group


DOI: 10.1136/ebmental-2019-300113