What Antidepressants Can Help Treat Alzheimer's Symptoms?

Although cognitive issues are the hallmark of Alzheimer’s disease, there are other symptoms that may arise that are just as important to address, including depression. Managing behavioral symptoms not only eases symptoms for the individual, but it also makes a difference in relationships with family members and makes caregiving easier as well. Behavioral symptoms commonly seen in those with Alzheimer’s can include anxiety, aggression or agitation, restlessness, wandering, sleeplessness, and depression.¹ Depression is especially common in those with early and middle-stage Alzheimer’s.¹

It’s not always easy to differentiate depression symptoms from general dementia symptoms. Symptoms of both can include loss of interest in things previously enjoyed, social withdrawal, isolation, concentration problems, apathy, and cognitive impairment.²

Up to 50 percent of people with Alzheimer’s disease experience either depression or clinically significant depressive symptoms during their experience of Alzheimer’s.³ Individuals with Alzheimer’s may not get prompt treatment for their depression because of this, especially if they aren’t able to articulate their feelings. If a caregiver is concerned about depression, talk to the person’s doctor about this possibility and what can be done to help treat it.

Treatment for depression in individuals with Alzheimer’s disease usually consists of medication, counseling, and helping them reconnect with people or activities they used to enjoy and that bring them happiness, which also decreases their sense of isolation.

Selective serotonin reuptake inhibitors

Although there are various classes of antidepressants available, selective serotonin reuptake inhibitors (SSRIs) are often prescribed for those with Alzheimer’s disease because of their low risk of drug interactions with other drugs typically used for Alzheimer’s.² They work primarily on a neurotransmitter called serotonin. Neurotransmitters help carry signals between brain cells, and SSRIs block serotonin from being absorbed by some of the brain cells, keeping more serotonin available in the brain, and boosting mood.

There are different FDA-approved SSRIs available to treat depression, including⁴:

• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Paroxetine (Paxil)

Side effects

As with any drug or supplement, there may be side effects when taking antidepressants, especially in the beginning, before the body gets used to them. It can take several weeks before antidepressants start to work, so it’s important to keep that in mind, as well.

Many side effects resolve on their own after a few weeks, but if they persist, or cause you discomfort, tell the doctor. The person might need to try a different SSRI. In addition, some of these antidepressants can make cognitive impairments worse, and therefore it is important to see a neurologist or geriatrician who understands the effects of these drugs on cognition, especially in individuals over the age of 65.

Possible side effects of SSRIs can include⁴:

• Drowsiness/fatigue
• Dry mouth
• Nausea
• Insomnia
• Headache
• Blurry vision
• Diarrhea

These are not all the possible side effects of SSRIs. Patients should talk to their doctor about what to expect with treatment with SSRIs.

An individual might experience one or more of these symptoms, or they may experience none. Everyone reacts differently to these medications. Adjusting dosing time may alleviate some side effects, so talk to your health care provider about proper administration and any side effects that occur.

Antidepressants can be a valuable addition to an Alzheimer’s treatment plan. Depression can negatively interfere with cognition and memory, impair social interactions and daily functioning.³ Addressing depression can also help to reduce other behavioral symptoms and promote a better quality of life. Talk with the doctor about whether an antidepressant might be beneficial for an individual. Let her know about any other medications or supplements the person is taking, to minimize adverse interactions. If the person tries one drug and has a negative experience, there are other SSRIs they can try; it’s worth finding one that works for the person.