Gender, aggression and serotonergic function are associated with response to sertraline for behavioral disturbances in Alzheimer's disease

Int J Geriatr Psychiatry. 2002 Jun;17(6):531-41. doi: 10.1002/gps.636.

Abstract

Background: Indications for serotonergic medications in the treatment of behavioral disorders associated with Alzheimer's disease (AD) remain to be established.

Method: Sertraline (100 mg OD) was evaluated in a double-blind, randomized, placebo-controlled cross-over study in 22 nondepressed patients with severe probable AD and significant behavioral disturbance. Each subject was given a fenfluramine challenge to evaluate central serotonergic tone.

Results: Eight of 21 (38%) completers responded to sertraline. Drug responsive behaviors included aggression/agitation, irritability and aberrant motor behavior. Low aggression, female gender and large prolactin increase were associated with a better response. There was a trend for decreased aggression during sertraline versus placebo (p = 0.08).

Conclusion: Aggression, gender and serotonergic function were associated with sertraline response. Larger randomized controlled trials are needed to clarify the profile of responders.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aggression*
  • Alzheimer Disease / complications
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / physiopathology
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Receptors, Serotonin / drug effects
  • Receptors, Serotonin / physiology
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Sertraline / pharmacology*
  • Sex Factors
  • Treatment Outcome

Substances

  • Receptors, Serotonin
  • Serotonin Uptake Inhibitors
  • Sertraline