[Serotonin reuptake inhibitors in depression of Alzheimer's disease and other dementias].

RATIONALE IN ALZHEIMER'S DISEASE: Selective serotonine uptake inhibitors (SSRI) have demonstrated their effectiveness for symptomatic treatment of depression, as well as for behavioral and psychological disorders in dementia patients, particularly in Alzheimer's disease.

UNASSIGNED

SSRI are particularly well tolerated, particularly in comparison with tricyclic antidepressants. Nausea and vomiting may be a problem in old demented patients. Safety studies have shown that tolerance is not modified in patients with Alzheimer's disease. DRUG INTERACTIONS AND PHARMACOKINETICS: Fluoxetine and paroxetine have an inhibiting effect on metabolism of cholinesterase inhibitors which should be avoided. The compounds have a short half-life and non-active metabolites should be preferred. TRAZODONE: Studies conducted in patients with Alzheimer's disease, mixed type dementia, or fronto-temporal dementia have shown the efficacy of trazodone for diverse types of symptoms: sadness, emotional disorders, irritability, fear, psychomotor instability, delirant ideas. Efficacy of SSRI in patients with Lewy body dementia remains to be confirmed.