Limited evidence for benefits of antidepressants in dementia

Limited evidence for benefits of antidepressants in dementia

Brian McAvoy
Clinical question

How effective are antidepressants in the treatment of patients with dementia?

Bottom line

There was little or no difference in scores on depression rating scales between people with dementia treated with antidepressants and those treated with placebo for 12 weeks (high-quality evidence). There was also little or no difference after 6 to 9 months of treatment. Moderate‐quality evidence showed antidepressants increased short‐term remission rates. Antidepressants did not affect the ability to manage daily activities and had little or no effect on a test of cognitive function (which includes attention, memory and language). People taking an antidepressant were more likely to drop out of treatment and to have at least one unwanted side effect.


The quality of the evidence varied, mainly due to poorly conducted studies and problems with the relevance of the outcome measures used. On average, the studies lasted only 12 weeks, although one study ran for 9 months.


Depression can be hard to recognise in people with dementia, but there is evidence that it is common and associated with increased disability, poorer quality of life and shorter life expectancy. Many people with dementia are prescribed antidepressants to treat depression, but there is uncertainty about how effective this is.

Cochrane Systematic Review

Dudas R et al. Antidepressants for treating depression in dementia. Cochrane Reviews, 2018, Issue 8. Art. No.: CD003944.DOI: 10.1002/14651858. CD003944.pub2. This review contains 10 studies involving 1592 participants.