Mirtazapine for treatment of depression and comorbidities in Alzheimer disease

Mukaila Raji, S. R. Brady

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

BACKGROUND: Depression in patients with Alzheimer disease is a treatable cause of functional decline, caregiver burden, and mortality. It is often associated with severe weight loss, insomnia, and anxiety. These symptoms independently and collaboratively further worsen the prognosis of these vulnerable patients. An antidepressant medication with good adverse effect profile and salutary effects on these comorbid symptoms may be of significant therapeutic value in these patients. OBJECTIVE: To describe the role of mirtazapine in the treatment of depressed Alzheimer patients with comorbid weight loss, insomnia, and anxiety. CASE SUMMARY: Three patients with dementia and depression complicated by weight loss, insomnia, and anxiety were treated with mirtazapine at an outpatient memory loss clinic of a university hospital. DISCUSSION: Despite the persistence of memory loss, the patients experienced a prompt and sustained response to mirtazapine. There was a complete remission of poor appetite, weight loss, sleep disturbances, and anxiety. Other depression symptoms, including sad mood, anhedonia, and energy level, were also substantially improved. CONCLUSIONS: The clinical response of our patients underscores the usefulness of mirtazapine in the treatment of the comorbid symptoms of weight loss, insomnia, and anxiety. The effectiveness of mirtazapine in depressed Alzheimer patients may be a reflection of its enhancement of brain serotonergic and noradrenergic neurotransmission. The usefulness of mirtazapine in depressed Alzheimer patients merits further study in a large randomized, controlled, clinically comparative trial.

Original languageEnglish (US)
Pages (from-to)1024-1027
Number of pages4
JournalAnnals of Pharmacotherapy
Volume35
Issue number9
StatePublished - 2001

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Comorbidity
Alzheimer Disease
Depression
Sleep Initiation and Maintenance Disorders
Weight Loss
Anxiety
Therapeutics
Memory Disorders
Anhedonia
mirtazapine
Appetite
Synaptic Transmission
Antidepressive Agents
Caregivers
Dementia
Sleep
Outpatients
Mortality
Brain

Keywords

  • Alzheimer disease
  • Depression
  • Mirtazapine

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Mirtazapine for treatment of depression and comorbidities in Alzheimer disease. / Raji, Mukaila; Brady, S. R.

In: Annals of Pharmacotherapy, Vol. 35, No. 9, 2001, p. 1024-1027.

Research output: Contribution to journalArticle

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