Findings published in The American Journal of Geriatric Psychiatry indicate that sertraline may be a viable treatment option for depression in patients with vascular cognitive impairment (VCI).
Researchers conducted an 8-week open-label flexible dose treatment study in 26 participants with VCI who scored at least 8 points on the Cornell Scale for Depression in Dementia (CSDD). Patients were administered sertraline at a target dose of 100 mg across the study period, and were assessed for depressive symptoms at baseline and then at weeks 2, 4, and 8. Paired sample t-tests quantified change between baseline and week 8.
Across 8 weeks, patients were administered a mean daily dose of 117 mg and showed an overall improvement in total CSDD score (P <.001). Subscores for mood (P <.001), behavioral (P =.005) and ideational (P =.001) disturbances, physical signs (P =.002), and cyclical functions (P =.002) also improved over the course of treatment. According to the Clinical Global Impression of Change, 4 (19%) completers were “very much improved,” 5 (23%) were “much improved,” 7 (33%) were “minimally improved,” 2 (10%) were “no change,” and 3 (14%) were “minimally worse.” Gastrointestinal side effects were reported by 12 completers, although the medication was overall well-tolerated.
“In this open trial, depressed participants with VCI completing 8 weeks of sertraline improved on depression, global clinical outcome, and a memory task,” the researchers wrote. “[While] placebo response is possible, another hypothesis for differences is that antidepressants may have varying success based on neuropathology. Alternately, higher doses of sertraline could be necessary.”
The investigators noted that a placebo-controlled study could further clarify these results and possibly strengthen the case for antidepressant treatment for depression in VCI.
Disclosures: Supported in part by Pfizer, Inc. (investigator initiated award) and the US Department of Veterans Affairs.
Weissberger GH, Yarns BC, Chen ST, Narvaez T, Bussel N, Sultzer DL. Sertraline for the treatment of depression in vascular cognitive impairment [published online April 25, 2018]. American J Geriatr Psychiatry. doi:10.1016/j.jagp.2018.04.006