Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain.
J Alzheimers Dis. 2022;88(2):707-720. doi: 10.3233/JAD-215630.
Depression is a common manifestation in Alzheimer's disease (AD). In clinical practice, antidepressant medication is often used for depression in AD.
We explore the effectiveness of the atypical antidepressant tianeptine compared with other conventional antidepressants in AD patients with depression in a real-life setting.
We retrospectively identified 126 AD patients who had received antidepressant treatment for 12 months with tianeptine or other antidepressants. Subjects were divided into two groups according to the treatment they had received: tianeptine group (n = 38) or other antidepressant group (n = 88). Drug effects on depression, cognition, behavior, and functional performance were evaluated at baseline, 6, and 12 months. A Mixed Effects Model Analysis was carried out to evaluate changes in performance scores.
Both tianeptine and other antidepressants showed an antidepressant effect after 12 months with significant improvement on the Cornell Scale for Depression in Dementia, the Hamilton Depression Rating Scale, and the Neuropsychiatric Inventory-Depression subscale. A statistically significant improvement at 12 months was shown in the tianeptine group versus the other antidepressants group on most of the cognitive measures such as the Mini-Mental State Examination, the Letter and Category Fluency Test, the Rey Auditory Verbal Learning Test, and the Boston Naming Test.
Our results suggest that tianeptine reduces depressive symptoms and improves cognition in AD patients. This could be considered clinically relevant and should inspire the design of future long-term randomized controlled trials that contribute to supporting the use of tianeptine for improving cognitive function in AD patients.
抑郁症是阿尔茨海默病(AD)的常见表现。在临床实践中,经常使用抗抑郁药治疗 AD 患者的抑郁症。
我们在真实环境中探索了非典型抗抑郁药噻奈普汀与其他常规抗抑郁药在 AD 伴发抑郁症患者中的疗效。
我们回顾性确定了 126 名接受噻奈普汀或其他抗抑郁药治疗 12 个月的 AD 患者。根据他们接受的治疗将受试者分为两组:噻奈普汀组(n=38)或其他抗抑郁药组(n=88)。在基线、6 个月和 12 个月时评估药物对抑郁、认知、行为和功能表现的影响。采用混合效应模型分析评估表现评分的变化。
噻奈普汀和其他抗抑郁药在 12 个月后均显示出抗抑郁作用,在痴呆康奈尔抑郁量表、汉密尔顿抑郁评定量表和神经精神疾病问卷-抑郁分量表上均有显著改善。在 12 个月时,噻奈普汀组在大多数认知测试(如简易精神状态检查、字母和类别流畅性测验、 Rey 听觉言语学习测验和波士顿命名测验)上的评分均显示出与其他抗抑郁药组相比具有统计学意义的改善。
我们的结果表明,噻奈普汀可减轻 AD 患者的抑郁症状并改善认知功能。这在临床上可能具有重要意义,应激发未来设计长期随机对照试验,以支持使用噻奈普汀改善 AD 患者的认知功能。