Complications (1)
- Alzheimer's: Managing sleep problems
Definition (1)
- Early-onset Alzheimer's: When symptoms begin before 65
Risk factors (2)
- Alzheimer's: Is it in your genes?
- Diabetes and Alzheimer's linked
Symptoms (3)
- Alzheimer's stages: How the disease progresses
- Memory loss: When to seek help
- Alzheimer's or depression: Could it be both?
Tests and diagnosis (3)
- Diagnosing Alzheimer's: An interview with a Mayo Clinic specialist
- SPECT scan
- Positron emission tomography (PET) scan
Treatments and drugs (3)
- Alzheimer's: Getting the most from medical appointments
- Alzheimer's drugs slow progression of disease
- Alzheimer's treatments: What's on the horizon?
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continued:
Alzheimer's or depression: Could it be both?
Treatment
Support groups and professional counseling may help persons with depression in the early stages of Alzheimer's disease, before their communication skills deteriorate. Regular physical exercise, particularly in the morning, also seems to ease the symptoms of depression. But the most common treatment is prescription antidepressants.
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the first line antidepressants used for people who have depression and Alzheimer's because of the low risk of side effects and drug interactions. SSRIs include citalopram (Celexa), sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac).
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
SNRIs are often tried next if the SSRIs don't work. However, SNRIs — which include venlafaxine (Effexor), mirtazapine (Remeron) and bupropion (Wellbutrin) — have more side effects, such as sedation, dry mouth and constipation.
Tricyclic antidepressants
These older antidepressants, such as nortriptyline (Pamelor) and desipramine (Norpramin), are no longer used as first-choice treatments because they can cause significant side effects, including increased confusion. However, they may be prescribed if other medications aren't effective.
When medications don't help
Some people with depression and dementia may not respond to medication. In many of these cases, electroconvulsive therapy can help relieve symptoms of severe depression. The procedure delivers electricity to the brain for a few seconds, to trigger a seizure. It's performed under general anesthesia in a hospital.
Electroconvulsive therapy is used more frequently for older people than for younger people — perhaps because older people may have more side effects from antidepressants or have more severe complications from severe depression.
What's the link?
Scientists aren't sure of the exact relationship between Alzheimer's disease and depression. Some research has found that the biological changes caused by Alzheimer's may intensify genetic predisposition to depression. Other studies suggest that the presence of depression may increase your chances of developing Alzheimer's disease.
It's clear that depression has a strong effect on quality of life for people with Alzheimer's disease. Depression can lead to:
- Weight loss
- Physical fragility
- Earlier placement in nursing homes
- Greater disability involving daily living skills
- Physical aggression toward caregivers
Finding the proper diagnosis and getting appropriate treatment can help make life easier and more enjoyable for both the person with Alzheimer's and his or her caregivers.
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