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Long-term SSRI treatment may delay progression from MCI to Alzheimer’s

Long-term selective serotonin reuptake inhibitor treatment was associated with significantly delayed progression from mild cognitive impairment to Alzheimer’s dementia.

“Experiments in animal models have suggested that selective serotonin reuptake inhibitors (SSRIs) may reduce amyloid plaque burden and cognitive impairment, presumably by shifting the balance from pro- toward non-amyloidogenic processing of the amyloid precursor protein,” Claudia Bartels, PhD, of University Medical Center Göttingen, Germany, and colleagues wrote. “In cognitively normal humans, long-term medication with the SSRI citalopram has been found to be associated with lower amyloid plaque load, and acute treatment with citalopram was found to reduce the rate of newly generated amyloid-.”

To assess the impact of SSRI treatment on cerebrospinal fluid (CSF) biomarkers and progression to from mild cognitive impairment to Alzheimer’s dementia, researchers conducted Kaplan-Meier analysis and analyses of variance and covariance with ApoE4 status and age as covariates among data for 755 currently nondepressed participants from the Alzheimer’s Disease Neuroimaging Initiative.

Long-term SSRI treatment, defined as more than 4 years, was associated with a 3-year delay in progression to Alzheimer’s dementia among individuals with mild cognitive impairment, compared with other antidepressant treatment or no treatment and with participants with mild cognitive impairment without a history of depression.

CSF biomarkers did not differ between treatment groups, according to researchers.

“Pending validation in an intervention trial, the data produced in this study may have important implications for clinical practice. They suggest that long-term SSRI maintenance treatment may be beneficial in elderly patients with [mild cognitive impairment] and a history of depression even after affective symptoms have resolved, as this was associated with a 3-year delay in conversion of [mild cognitive impairment] to Alzheimer’s dementia,” the researchers concluded. – by Amanda Oldt

Disclosures: Bartels reports receiving support in part from the German Frontotemporal Lobar Degeneration consortium (Federal Ministry of Education and Research-Competence Network Degenerative Dementias. Please see the study for all other authors’ relevant financial disclosures.