Antidepressants in Elderly Patients with Behavioural and Psychological Symptoms of Dementia: A Review of Clinical Effectiveness and Guidelines

Question

1. What is the clinical effectiveness and safety of antidepressants in elderly patients with behavioural and psychological symptoms of dementia in any setting (home, long-term care, or hospital)?
2. What are the evidence-based guidelines associated with the use of antidepressants in elderly patients with behavioural and psychological symptoms of dementia in any setting (home, long-term care, or hospital)?

Key Message

There were no health technology assessment reports, systematic reviews, meta-analyses, randomized controlled trials or non-RCTs identified that compared the efficacy or safety of an antidepressant to another antidepressant, placebo, St. John's Wort or a behavioural intervention in elderly patients (aged 65 and over) with behavioural and psychological symptoms of dementia. One evidence-based guideline included recommendations for the use of antidepressants as an alternative to help manage inappropriate sexual behaviours, agitation, apathy, and sleep disturbances. These recommendations were based upon low quality evidence.