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Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial.

Publication ,  Journal Article
Devanand, DP; Pelton, GH; D'Antonio, K; Ciarleglio, A; Scodes, J; Andrews, H; Lunsford, J; Beyer, JL; Petrella, JR; Sneed, J; Ciovacco, M ...
Published in: Am J Geriatr Psychiatry
October 2018

OBJECTIVE: Depression and cognitive impairment are often comorbid in older adults, but optimal treatment strategies remain unclear. In a two-site study, the efficacy and safety of add-on donepezil versus placebo were compared in depressed patients with cognitive impairment receiving stable antidepressant treatment. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in older adults with depression and cognitive impairment (https://clinicaltrials.gov/ct2/show/NCT01658228; NCT01658228). Patients received open-label antidepressant treatment for 16 weeks, initially with citalopram and then with venlafaxine, if needed, followed by random assignment to add-on donepezil 5-10 mg daily or placebo for another 62 weeks. Outcome measures were neuropsychological test performance (Alzheimer's Disease Assessment Scale-Cognitive subscale [ADAS-Cog] and Selective Reminding Test [SRT] total immediate recall) and instrumental activities of daily living (Functional Activities Questionnaire). RESULTS: Of 81 patients who signed informed consent, 79 patients completed the baseline evaluation. Open antidepressant treatment was associated with improvement in depression in 63.93% responders by week 16. In the randomized trial, there were no treatment group differences between donepezil and placebo on dementia conversion rates, ADAS-Cog, SRT total immediate recall, or FAQ. Neither baseline cognitive impairment severity nor apolipoprotein E e4 genotype influenced donepezil efficacy. Donepezil was associated with more adverse effects than placebo. CONCLUSION: The results do not support adjunctive off-label cholinesterase inhibitor treatment in patients with depression and cognitive impairment. The findings highlight the need to prioritize discovery of novel treatments for this highly prevalent population with comorbid illnesses.

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Published In

Am J Geriatr Psychiatry

DOI

EISSN

1545-7214

Publication Date

October 2018

Volume

26

Issue

10

Start / End Page

1050 / 1060

Location

England

Related Subject Headings

  • Outcome Assessment, Health Care
  • Off-Label Use
  • Middle Aged
  • Male
  • Humans
  • Geriatrics
  • Female
  • Drug Therapy, Combination
  • Double-Blind Method
  • Donepezil
 

Citation

APA
Chicago
ICMJE
MLA
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Devanand, D. P., Pelton, G. H., D’Antonio, K., Ciarleglio, A., Scodes, J., Andrews, H., … Doraiswamy, P. M. (2018). Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial. Am J Geriatr Psychiatry, 26(10), 1050–1060. https://doi.org/10.1016/j.jagp.2018.05.008
Devanand, Davangere P., Gregory H. Pelton, Kristina D’Antonio, Adam Ciarleglio, Jennifer Scodes, Howard Andrews, Julia Lunsford, et al. “Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial.Am J Geriatr Psychiatry 26, no. 10 (October 2018): 1050–60. https://doi.org/10.1016/j.jagp.2018.05.008.
Devanand DP, Pelton GH, D’Antonio K, Ciarleglio A, Scodes J, Andrews H, et al. Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial. Am J Geriatr Psychiatry. 2018 Oct;26(10):1050–60.
Devanand, Davangere P., et al. “Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial.Am J Geriatr Psychiatry, vol. 26, no. 10, Oct. 2018, pp. 1050–60. Pubmed, doi:10.1016/j.jagp.2018.05.008.
Devanand DP, Pelton GH, D’Antonio K, Ciarleglio A, Scodes J, Andrews H, Lunsford J, Beyer JL, Petrella JR, Sneed J, Ciovacco M, Doraiswamy PM. Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial. Am J Geriatr Psychiatry. 2018 Oct;26(10):1050–1060.
Journal cover image

Published In

Am J Geriatr Psychiatry

DOI

EISSN

1545-7214

Publication Date

October 2018

Volume

26

Issue

10

Start / End Page

1050 / 1060

Location

England

Related Subject Headings

  • Outcome Assessment, Health Care
  • Off-Label Use
  • Middle Aged
  • Male
  • Humans
  • Geriatrics
  • Female
  • Drug Therapy, Combination
  • Double-Blind Method
  • Donepezil