While citalopram has been used to reduce agitation and aggression in individuals with Alzheimer’s disease (AD), a new study published in the Journal of the America Medical Association suggests that use of the drug in these patients may be increasing their health risks.
Researchers from Johns Hopkins Bayview Medical Center and the University of Rochester Medical Center randomized 186 nondepressed patients with AD to received nine weeks of psychosocial therapy plus either citalopram or placebo to evaluate the efficacy of 30mg per day of citalopram for AD-associated agitation—which affects 90% of patients with AD, according to study. Results showed that 40% of the patients receiving citalopram had improvements in agitation from baseline, compared with 26% of placebo recipients. However, the patients taking citalopram had longer QT intervals—a measure of abnormal heart functions that greatly increases the risk for heart attacks—than did the placebo group.

Constantine Lyketsos, M.D., M.H.S, coauthor and director of psychiatry at Johns Hopkins Bayview, commented in statement that he and his colleagues plan to investigate the effectiveness of lower doses of citalopram in treating AD-related agitation, a strategy that may pose less cardiovascular risk. In the meantime, Lyketsos said, the drug offers an alternative to treating agitation in individuals with AD who may be nonresponsive to nonmedication treatments.