Is sertraline treatment or depression remission in depressed Alzheimer patients
associated with improved caregiver well being? Depression in Alzheimer's Disease
Study 2.
Author(s): Flynn Longmire CV(1), Drye LT, Frangakis CE, Martin BK, Meinert CL, Mintzer JE,
Munro CA, Porsteinsson AP, Rabins PV, Rosenberg PB, Schneider LS, Weintraub D,
Lyketsos CG; DIADS-2 Research Group.
Affiliation(s): Author information:
(1)Medical University of South Carolina, Department of Neurosciences, Charleston,
SC. Electronic address: crystalflynn@hotmail.com.
Publication date & source: 2014, Am J Geriatr Psychiatry. , 22(1):14-24
OBJECTIVE: We wanted to assess if sertraline treatment (versus placebo) or
remission of depression at 12 weeks (versus nonremission) in Alzheimer patients
is associated with improved caregiver well being.
METHODS: We conducted a randomized, double-blind, placebo-controlled clinical
trial of the efficacy and safety of sertraline for the treatment of depression in
individuals with Alzheimer disease in five clinical research sites across the
United States. Participants were caregivers of patients enrolled in the
Depression in Alzheimer's Disease Study 2 (N = 131). All caregivers received
standardized psychosocial support throughout the study. Caregiver outcome
measures included depression (Beck Depression Inventory), distress
(Neuropsychiatric Inventory), burden (Zarit Burden Interview), and quality of
life (Medical Outcomes Study Short Form Health Survey).
RESULTS: Fifty-nine percent of caregivers were spouses, 63.4% were women, and
64.1% were white. Caregivers of patients in both treatment groups had significant
reductions in distress scores over the 24-week study period, but there was not a
greater benefit for caregivers of patients taking sertraline. However, caregivers
of patients whose depression was in remission at week 12 had greater declines in
distress scores over the 24 weeks than caregivers of patients whose depression
did not remit by week 12.
CONCLUSION: Patient treatment with sertraline was not associated with
significantly greater reductions in caregiver distress than placebo treatment.
Distress but not level of depression or burden lessened for all caregivers
regardless of remission status and even more so for those who cared for patients
whose depression remitted. Results imply an interrelationship between caregiver
distress and patient psychiatric outcomes.
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