Antidepressant May Deter Progression of Alzheimer’s Disease

VBCN - July 2014 Volume 1, No 2

The often-prescribed antidepressant citalopram (Celexa), a selective serotonin reuptake inhibitor (SSRI), appears to reduce the formation of amyloid plaques that are associated with Alzheimer’s disease, according to new research in mice and a small cohort of healthy individuals (Sheline YI, et al. Sci Transl Med. 2014;6:236re4). The accumulation of amyloid-beta peptide in the brain and its aggregation into amyloid plaques are currently considered triggers in the pathogenesis of Alzheimer’s disease. The study findings support preliminary animal studies that tested a variety of SSRIs on lowering concentrations of amyloid.

A new randomized, double-blind, placebo-controlled study was performed to determine the central nervous system effect of 60 mg of citalopram (given in 2 doses of 30 mg each) in 23 healthy patients aged 18 to 50 years who were not cognitively impaired or depressed. Patients were randomized to placebo or to a dose of 30 mg of citalopram 8 hours and 6 hours before the start of the labeling study. The production and concentrations in cerebrospinal fluid (CSF) of amyloid beta were measured prospectively using stable isotope labeling kinetics, with CSF sampling during the acute dosing of citalopram. Treatment with citalopram was associated with a 38% decrease in total CSF amyloid-beta concentrations over the 37-hour sampling period compared with placebo. Furthermore, the mean production rate of amyloid beta within CSF calculated over 13 to 22 hours was significantly lower in the group receiving citalopram versus the group receiving placebo, resulting in a 37% decrease in the production of amyloid beta.

These findings demonstrate that the ability to safely decrease the concentration of amyloid beta is potentially important as a preventive strategy for Alzheimer’s disease. Prospective trials in older, cognitively normal individuals should now test SSRI exposure to determine if the reduction in amyloid beta is sustainable.

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