Dudas R, Malouf R, McCleery J and Dening T. Antidepressants for treating depression in dementia. Cochrane Database Syst Rev. 2018;(8):CD003944.
Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term.
This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. Participants were aged 75 years on average, with mild or moderate dementia. The quality of the included trials was mixed, with not enough information reported to fully assess the risk of bias, though the main result is reliable.
This review supports the NICE guideline, which recommends that antidepressants are not routinely offered to people with dementia and depression, but that psychological treatments are considered instead.