Publication

Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia: Findings From the HTA-SADD Randomized Controlled Trial

HTA-SADD Investigator Grp, Zuidersma, M., Chua, K-C., Hellier, J., Voshaar, R. O. & Banerjee, S., Sep-2019, In : American Journal of Geriatric Psychiatry. 27, 9, p. 920-931 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

HTA-SADD Investigator Grp, Zuidersma, M., Chua, K-C., Hellier, J., Voshaar, R. O., & Banerjee, S. (2019). Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia: Findings From the HTA-SADD Randomized Controlled Trial. American Journal of Geriatric Psychiatry, 27(9), 920-931. https://doi.org/10.1016/j.jagp.2019.03.021

Author

HTA-SADD Investigator Grp ; Zuidersma, Marij ; Chua, Kia-Chong ; Hellier, Jennifer ; Voshaar, Richard Oude ; Banerjee, Sube. / Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia : Findings From the HTA-SADD Randomized Controlled Trial. In: American Journal of Geriatric Psychiatry. 2019 ; Vol. 27, No. 9. pp. 920-931.

Harvard

HTA-SADD Investigator Grp, Zuidersma, M, Chua, K-C, Hellier, J, Voshaar, RO & Banerjee, S 2019, 'Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia: Findings From the HTA-SADD Randomized Controlled Trial', American Journal of Geriatric Psychiatry, vol. 27, no. 9, pp. 920-931. https://doi.org/10.1016/j.jagp.2019.03.021

Standard

Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia : Findings From the HTA-SADD Randomized Controlled Trial. / HTA-SADD Investigator Grp ; Zuidersma, Marij; Chua, Kia-Chong; Hellier, Jennifer; Voshaar, Richard Oude; Banerjee, Sube.

In: American Journal of Geriatric Psychiatry, Vol. 27, No. 9, 09.2019, p. 920-931.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

HTA-SADD Investigator Grp, Zuidersma M, Chua K-C, Hellier J, Voshaar RO, Banerjee S. Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia: Findings From the HTA-SADD Randomized Controlled Trial. American Journal of Geriatric Psychiatry. 2019 Sep;27(9):920-931. https://doi.org/10.1016/j.jagp.2019.03.021


BibTeX

@article{14ff9b559e0f4229b9c412a13ecb3494,
title = "Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia: Findings From the HTA-SADD Randomized Controlled Trial",
abstract = "Objective: Studies have shown that antidepressants are no better than placebo in treating depression in dementia. The authors examined antidepressant efficacy in subgroups of depression in dementia with different depressive symptom profiles. Methods: This study focuses on exploratory secondary analyses on the randomized, parallel-group, double-blind, placebo-controlled Health Technology Assessment Study of the Use of Antidepressants for Depression in Dementia (HTA-SADD) trial. The setting included old-age psychiatry services in nine centers in England. The participants included 326 patients meeting National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association probable/possible Alzheimer disease criteria, and Cornell Scale for Depression in Dementia (CSDD) scores of 8 or more. Intervention was placebo (n = 111), sertraline (n = 107), or mirtazapine (n = 108). Latent class analyses (LCA) on baseline CSDD items clustered participants into symptom-based subgroups. Mixed-model analysis evaluated CSDD improvement at 13 and 39 weeks by randomization in each subgroup. Results: LCA yielded 4 subgroups: severe (n = 34), psychological (n = 86), affective (n = 129), and somatic (n = 77). Mirtazapine, but not sertraline, outperformed placebo in the psychological subgroup at week 13 (adjusted estimate: -2.77 [standard error (SE) 1.16; 95{\%} confidence interval: -5.09 to -0.46]), which remained, but lost statistical significance at week 39 (adjusted estimate: -2.97 [SE 1.59; 95{\%} confidence interval: -6.15 to 0.20]). Neither sertraline nor mirtazapine outperformed placebo in the other subgroups. Conclusion: Because of the exploratory nature of the analyses and the small sample sizes for subgroup analysis there is the need for caution in interpreting these data. Replication of the potential effects of mirtazapine in the subgroup of those with depression in dementia with {"}psychological{"} symptoms would be valuable. These data should not change clinical practice, but future trials should consider stratifying types of depression in dementia in secondary analyses.",
keywords = "Depression, dementia, randomized controlled trial, mirtazapine, sertraline, latent class analyses, ALZHEIMER-DISEASE, EFFICACY, MANAGEMENT, MEDICATION, SYMPTOMS, SAMPLE",
author = "{HTA-SADD Investigator Grp} and Marij Zuidersma and Kia-Chong Chua and Jennifer Hellier and Voshaar, {Richard Oude} and Sube Banerjee",
year = "2019",
month = "9",
doi = "10.1016/j.jagp.2019.03.021",
language = "English",
volume = "27",
pages = "920--931",
journal = "American Journal of Geriatric Psychiatry",
issn = "1064-7481",
publisher = "ELSEVIER SCIENCE INC",
number = "9",

}

RIS

TY - JOUR

T1 - Sertraline and Mirtazapine Versus Placebo in Subgroups of Depression in Dementia

T2 - Findings From the HTA-SADD Randomized Controlled Trial

AU - HTA-SADD Investigator Grp

AU - Zuidersma, Marij

AU - Chua, Kia-Chong

AU - Hellier, Jennifer

AU - Voshaar, Richard Oude

AU - Banerjee, Sube

PY - 2019/9

Y1 - 2019/9

N2 - Objective: Studies have shown that antidepressants are no better than placebo in treating depression in dementia. The authors examined antidepressant efficacy in subgroups of depression in dementia with different depressive symptom profiles. Methods: This study focuses on exploratory secondary analyses on the randomized, parallel-group, double-blind, placebo-controlled Health Technology Assessment Study of the Use of Antidepressants for Depression in Dementia (HTA-SADD) trial. The setting included old-age psychiatry services in nine centers in England. The participants included 326 patients meeting National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association probable/possible Alzheimer disease criteria, and Cornell Scale for Depression in Dementia (CSDD) scores of 8 or more. Intervention was placebo (n = 111), sertraline (n = 107), or mirtazapine (n = 108). Latent class analyses (LCA) on baseline CSDD items clustered participants into symptom-based subgroups. Mixed-model analysis evaluated CSDD improvement at 13 and 39 weeks by randomization in each subgroup. Results: LCA yielded 4 subgroups: severe (n = 34), psychological (n = 86), affective (n = 129), and somatic (n = 77). Mirtazapine, but not sertraline, outperformed placebo in the psychological subgroup at week 13 (adjusted estimate: -2.77 [standard error (SE) 1.16; 95% confidence interval: -5.09 to -0.46]), which remained, but lost statistical significance at week 39 (adjusted estimate: -2.97 [SE 1.59; 95% confidence interval: -6.15 to 0.20]). Neither sertraline nor mirtazapine outperformed placebo in the other subgroups. Conclusion: Because of the exploratory nature of the analyses and the small sample sizes for subgroup analysis there is the need for caution in interpreting these data. Replication of the potential effects of mirtazapine in the subgroup of those with depression in dementia with "psychological" symptoms would be valuable. These data should not change clinical practice, but future trials should consider stratifying types of depression in dementia in secondary analyses.

AB - Objective: Studies have shown that antidepressants are no better than placebo in treating depression in dementia. The authors examined antidepressant efficacy in subgroups of depression in dementia with different depressive symptom profiles. Methods: This study focuses on exploratory secondary analyses on the randomized, parallel-group, double-blind, placebo-controlled Health Technology Assessment Study of the Use of Antidepressants for Depression in Dementia (HTA-SADD) trial. The setting included old-age psychiatry services in nine centers in England. The participants included 326 patients meeting National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association probable/possible Alzheimer disease criteria, and Cornell Scale for Depression in Dementia (CSDD) scores of 8 or more. Intervention was placebo (n = 111), sertraline (n = 107), or mirtazapine (n = 108). Latent class analyses (LCA) on baseline CSDD items clustered participants into symptom-based subgroups. Mixed-model analysis evaluated CSDD improvement at 13 and 39 weeks by randomization in each subgroup. Results: LCA yielded 4 subgroups: severe (n = 34), psychological (n = 86), affective (n = 129), and somatic (n = 77). Mirtazapine, but not sertraline, outperformed placebo in the psychological subgroup at week 13 (adjusted estimate: -2.77 [standard error (SE) 1.16; 95% confidence interval: -5.09 to -0.46]), which remained, but lost statistical significance at week 39 (adjusted estimate: -2.97 [SE 1.59; 95% confidence interval: -6.15 to 0.20]). Neither sertraline nor mirtazapine outperformed placebo in the other subgroups. Conclusion: Because of the exploratory nature of the analyses and the small sample sizes for subgroup analysis there is the need for caution in interpreting these data. Replication of the potential effects of mirtazapine in the subgroup of those with depression in dementia with "psychological" symptoms would be valuable. These data should not change clinical practice, but future trials should consider stratifying types of depression in dementia in secondary analyses.

KW - Depression

KW - dementia

KW - randomized controlled trial

KW - mirtazapine

KW - sertraline

KW - latent class analyses

KW - ALZHEIMER-DISEASE

KW - EFFICACY

KW - MANAGEMENT

KW - MEDICATION

KW - SYMPTOMS

KW - SAMPLE

U2 - 10.1016/j.jagp.2019.03.021

DO - 10.1016/j.jagp.2019.03.021

M3 - Article

VL - 27

SP - 920

EP - 931

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

SN - 1064-7481

IS - 9

ER -

ID: 97352187