Antidepressant drug doesn’t improve agitation in dementia trial

Researchers have found that the anti-depressant drug mirtazapine has no effect on agitation in a clinical trial in people with dementia. The journal Lancet published the results today (Thursday 21 October).

Over 200 study volunteers with agitation and dementia either received the drug, mirtazapine, commonly known as Remeron, or a dummy treatment.

Volunteers came from 26 sites across the UK.

The researchers followed volunteers, looked at scores on tests of agitation after 12 weeks.

They found no evidence that mirtazapine improved agitation compared to the dummy treatment.

While there were similar levels of adverse effects in both groups, the team found more deaths by week 16 in the volunteers who received mirtazapine (7) than in the group of volunteers who received the dummy treatment (1).

Dr James Connell, Head of Translational Science at Alzheimer’s Research UK, said:

“Dementia is not just about memory loss. Symptoms including agitation and aggression can all be particularly devastating symptoms that impact the lives of those with dementia, their carers and their loved ones. Current treatments for agitation in people with Alzheimer’s disease are not very effective, can only be used for short time periods, and have a number of side effects. “Well-conducted clinical trials are the only way to tell if potential treatments are effective and safe, however this study was not large enough to tell whether the small increase in deaths seen in people who took mirtazapine was due to the treatment or chance. “From every clinical trial we can learn something and while this trial suggests the use of mirtazapine to treat agitation in those with dementia is likely ineffective, given its wide-spread use in clinical practice further studies are warranted. The study also demonstrates the ability to run and complete a dementia clinical trial through the pandemic. “While there’s a major drive to produce a drug that slows or stops the underlying disease, treatments that act on symptoms like agitation would also have a real impact the day-to-day lives of people affected by dementia. Alzheimer’s Research UK is now funding clinical trials to try to help bring about new symptomatic treatments for agitation in dementia. “To bring about new treatments for dementia sooner, we need targeted investment to make the UK the go-to place for clinical research. We’re urging government to deliver on its manifesto promise to double the dementia research budget to £160m a year. Doing so will allow more people with dementia to participate in research, will mean more trials are completed successfully and ultimately speed up progress towards innovative new treatments.”

Alzheimer’s Research UK is funding a project looking at whether a cannabis-derived medicine help with symptoms of agitation in dementia.

You can read the full research, a ‘Study of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial’ by Banerjee et al., published in Lancet today 21/10/21