Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Adv Exp Med Biol. 2020;1260:267-281. doi: 10.1007/978-3-030-42667-5_10.
The link between depression and Alzheimer's disease (AD) is controversial, because it is not clear if depression is an independent risk factor for the disease or a prodromal symptom in the older population. Cerebral amyloid-β (Aβ) peptide deposition is associated with both cognitive symptoms and neuropsychiatric symptoms (NPS), which may be a biological mechanism of compensation. Despite the widespread use of antidepressant therapeutics (30-50% of patients with AD/dementia are on antidepressants), there is mixed evidence regarding the benefits from their use in AD depression. Monoaminergic antidepressant drugs have shown only modest or no clinical benefits. Therefore, it is important to understand the reason of this drug-resistance and the relationship between antidepressant drugs and the Aβ peptide. The goal of the present review is to highlight the etiology of depression in patients affected by AD in comparison to depressive disorders without AD, and to speculate on more appropriate and alternative therapeutics.
抑郁症与阿尔茨海默病（AD）之间的联系存在争议，因为目前尚不清楚抑郁症是否是该病的独立危险因素，还是老年人群中的前驱症状。脑淀粉样β（Aβ）肽沉积与认知症状和神经精神症状（NPS）有关，这可能是一种生物学补偿机制。尽管抗抑郁治疗药物（AD/痴呆患者中有 30-50%的患者正在服用抗抑郁药）的应用非常广泛，但关于其在 AD 抑郁症中的益处的证据存在分歧。单胺能抗抑郁药的临床获益仅为中等或无。因此，了解这种耐药性的原因以及抗抑郁药与 Aβ肽之间的关系非常重要。本综述的目的是强调与无 AD 的抑郁障碍相比，AD 患者的抑郁病因，并推测更合适和替代的治疗方法。
