Back to resultsMemantine Plus Es-citalopram in Elderly Depressed Patients With Cognitive Impairment
Primary Purpose
Mild Cognitive Impairment, Major Depressive Disorder, Alzheimer's Disease
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
es-citalopram
Memantine
Sponsored by
About this trial
This is an interventional treatment trial for Mild Cognitive Impairment focused on measuring Memory Decline, Depression, Elderly, Antidepressants, Treatment, memantine
Eligibility Criteria
Inclusion Criteria:
- Of either sex, age greater than 49 years old
- Meets criteria for both "depression" and "cognitive impairment".
Study Criteria for "depression":
i. Patients who meet DSM-IV criteria for Major Depression, Dysthymic Disorder, or Dysthymia symptoms criteria of minimum 6 month duration (not the 2 year DSM-IV criteria). ii. 24-item HAM-D greater than 13; and iii. Clinical Global Impression (CGI) for severity of Depression greater than 2 (absolute score at least mild to moderate depression on a 7-point scale)
Study Criteria for "cognitive deficit":
i. Subjective memory complaint ii.Mini Mental Status Exam (MMSE) greater than 24; and at least one of a, b, or c:
- less than 3 on MMSE 5 min delay on recall
- scores on 2 neuropsychological tests greater than 1 Standard Deviation (SD) below standardized norms, or
- score on 1 neuropsychological tests greater than 2 SD below standardized norms.
Neuropsychological tests for inclusion criteria (subset of larger battery):
Selective Reminding Test with delay Wechsler Memory Scale (WMS): Visual Reproduction - with delay, % savings from immed to delay Controlled Oral Word Association Test Trails B Digit symbol subtest of Wechsler Adult Intelligence Scale (WAIS)-III Continuous Performance Test iii. CGI for severity of Cognitive deficit greater than 2 (absolute score on a 7-point scale:1=no deficit to 7=severe deficit). iv. Clinical Dementia Rating (CDR) = 0 or 0.5
- Willing and capable of giving informed consent
Exclusion Criteria:
- Meets Criteria for dementia (DSM-IV) or probable Alzheimer's disease by National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria (NINCDS-ADRDA criteria)
Meets criteria for:
- schizophrenia
- alcohol or substance dependence or abuse within the last 6 months.
- Suicidal attempt in last 6 months or current suicidal intent.
- Patients currently on an effective antidepressant medication
- Use of cholinesterase inhibitors in the last year.
- Neurological disease including stroke, epilepsy, or other neurodegenerative disorders.
- An acute, severe or unstable medical condition such as metastatic or active cancer, hepatic disease, or primary renal disease requiring dialysis.
- Patients who can not tolerate being tapered off antidepressant medication (i.e. greater than a 25% incr. in baseline HAM-D) or has a history indicating patient is unlikely to tolerate psychotropic washout.
- Patient with a history of non-response to Citalopram or es-citalopram
Sites / Locations
- New York State Psychiatric Institute
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
es-citalopram and Memantine Treatment
Arm Description
concurrent es-citalopram plus memantine were administered for 48 weeks.
Outcomes
Primary Outcome Measures
Change in Selective Reminding Test - Total Immediate Recall (SRT-IR)
Change in Selective Reminding Test-Total Immediate Recall (SRT-IR) scores from baseline to Week 48: Measures word recall (maximum 12 words per trial, across 6 trials). Maximum total recall score across 6 trials is 72; minimum recall is 0 across 6 trials. The higher the raw score, the better the patient did at recalling the target words. The unit of measure is the raw score, or the sum of the number of words recalled across all 6 trials.
Secondary Outcome Measures
Change in Wechsler Memory Scale-III (WMS-III)
Change in Wechsler Memory Scale-III scores from baseline to Week 48: The WMS-III Visual Reproduction sub-test was used to measure visual working memory and delayed memory. Patients were shown pictures of four drawings and were asked to reproduce them from memory immediately after seeing them, and 25 minutes after seeing them. The four scores are summed and the greater the total raw score, the better the patient did on the assessment. The maximum raw score for this test is a 41 on both the immediate and delayed portions (the overall range is 0-82 points). The change score is calculated using the total scores of both the immediate and delayed portions.
Change in Selective Reminding Test - Delayed Recall (SRT-DR)
Change in Selective Reminding Test-Delayed Recall scores from baseline to Week 48: SRT Delay is administered 15 minutes after the immediate recall portion. Patients are asked to remember as many of the words as they can from the 6 trials. Maximum raw score is a 12 for free recall. If a patient is unable to recall a word, they are given a chance to recognize it among three incorrect word choices. Maximum raw score for recognition is 12. The greater the score on the delayed recall portion, the better the patient does on the assessment.
Change in Trails B
Change from baseline to Week 48 on Trails B: Measures attention and executive function. It asks patients to connect numbers and letters in numerical to alphabetical order from (1-13 and A-L) as fast as they can. Patients are timed; the longer it takes for the patient to connect the numbers and letters, the worse their score. Unit of measure is in seconds. The amount of errors that the patient makes during trails is also recorded.
Change in Trails A
Change in Trails A scores from baseline to Week 48: Measures attention and executive function. It asks patients to connect numbers from 1-25 in numerical order as fast as they can. Patients are timed; the longer it takes for the patient to connect the numbers, the worse their score. Unit of measure is in seconds. The amount of errors that the patient makes during trails is also recorded.
Full Information
NCT ID
NCT01876823
First Posted
June 5, 2013
Last Updated
October 23, 2014
Sponsor
New York State Psychiatric Institute
1. Study Identification
Unique Protocol Identification Number
NCT01876823
Brief Title
Memantine Plus Es-citalopram in Elderly Depressed Patients With Cognitive Impairment
Official Title
Effects of Combined Memantine (Namenda) Plus Escitalopram (Lexapro) Treatment in Elderly Depressed Patients With Cognitive Impairment
Study Type
Interventional
2. Study Status
Record Verification Date
September 2013
Overall Recruitment Status
Completed
Study Start Date
April 2006 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
March 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
New York State Psychiatric Institute
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Alzheimer's disease (AD), the most common dementing disorder of later life, is a major cause of disability and death in the elderly. Although a number of theoretical causes exist, the etiology of AD is still unknown. Consequently, the focus of treatments has been palliative, designed to ameliorate AD symptoms. Recent efforts, however, have revealed some surprising data suggesting that cholinesterase inhibitors (AchEIs), used over the last decade, and recently released memantine (an N-methyl-D-aspartate (NMDA) receptor antagonist), may confer protection to neurons. Thus, they may offer a slowing of cognitive decline and/or improvement in behavioral symptoms associated with memory impairment.
Over the last decade, it has been well documented that mild cognitive impairment (MCI) increases the risk of conversion to AD and that coincident depression and MCI (Dep-MCI) further increases the risk 2 to 3 fold. The primary focus of this line of investigation is to treat the very high risk to dement patient population with Dep-MCI, before they develop AD, in the hopes of delaying AD onset.
Memantine had not been studied in DEP-MCI patients. Since treatment of these patients with combined antidepressant and AChEIs has been associated with cognitive improvement in pilot studies, we explore whether treatment of DEP-MCI with memantine in addition to antidepressant treatment would benefit cognitive performance and lead to a low rate of conversion to dementia. We evaluate the cognitive and antidepressant benefit of combined open-label es-citalopram and memantine treatment over 48 weeks in a DEP-CI sample.
Detailed Description
The study is conducted in a sample of 35 elderly (50-90 years old) outpatients who meet study inclusion criteria for depression (DEP) (DSM-IV criteria for major depression, dysthymic disorder, or depression NOS) and mild cognitive impairment (MCI; e.g. operationally defined as between "normal" and "dementia"), i.e., Dep-MCI. The research plan includes: i) Obtaining a baseline psychiatric and neuropsychological test profile, ii) If currently on an ineffective antidepressant, having a one week washout (3 weeks for fluoxetine), iii) A treatment trial beginning with a two-week es-citalopram lead-in period. At two weeks, memantine (Namenda) is added starting at 5 mg/day and increased until the maximum dose of 20 mg/day is reached by six weeks. The study psychiatrist administers: the 24-item Hamilton Depression Rating Scale (HAM-D); the Clinical Global Impression (CGI, 1-7 scale) initial severity and subsequent change ratings separately for depression, cognition, and overall clinical status; the Treatment Emergent Symptom Scale (TESS) for somatic side effects. A trained technician administers the neuropsychological battery at baseline, 12, 24 and 48 weeks. If the patient is an antidepressant non-responder during the first 12-weeks, the es-citalopram is changed to an alternative antidepressant, as clinically indicated by the treating psychiatrist. The patient remains on the memantine for the entire 48-weeks, irrespective of antidepressant response.
This will tell us about the efficacy and tolerability of es-citalopram+memantine on both cognitive and depressive symptoms in Dep-MCI patients and will potentially have broader public health implications because Dep-MCI is a wide-spread clinical problem where management needs to be improved.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mild Cognitive Impairment, Major Depressive Disorder, Alzheimer's Disease
Keywords
Memory Decline, Depression, Elderly, Antidepressants, Treatment, memantine
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Actual)
8. Arms, Groups, and Interventions
Arm Title
es-citalopram and Memantine Treatment
Arm Type
Experimental
Arm Description
concurrent es-citalopram plus memantine were administered for 48 weeks.
Intervention Type
Drug
Intervention Name(s)
es-citalopram
Other Intervention Name(s)
Lexapro
Intervention Description
es-citalopram 10mg/day will be given for the first week, and 20mg/day starting at week 2.
Intervention Type
Drug
Intervention Name(s)
Memantine
Other Intervention Name(s)
Namenda
Intervention Description
After two weeks on Lexapro, Memantine 5mg will be added. The dose will increase to 10mg for the second week and will be increased at a rate of 5mg per week. Memantine dosage will not exceed 20mg.
Primary Outcome Measure Information:
Title
Change in Selective Reminding Test - Total Immediate Recall (SRT-IR)
Description
Change in Selective Reminding Test-Total Immediate Recall (SRT-IR) scores from baseline to Week 48: Measures word recall (maximum 12 words per trial, across 6 trials). Maximum total recall score across 6 trials is 72; minimum recall is 0 across 6 trials. The higher the raw score, the better the patient did at recalling the target words. The unit of measure is the raw score, or the sum of the number of words recalled across all 6 trials.
Time Frame
baseline, 48 weeks
Secondary Outcome Measure Information:
Title
Change in Wechsler Memory Scale-III (WMS-III)
Description
Change in Wechsler Memory Scale-III scores from baseline to Week 48: The WMS-III Visual Reproduction sub-test was used to measure visual working memory and delayed memory. Patients were shown pictures of four drawings and were asked to reproduce them from memory immediately after seeing them, and 25 minutes after seeing them. The four scores are summed and the greater the total raw score, the better the patient did on the assessment. The maximum raw score for this test is a 41 on both the immediate and delayed portions (the overall range is 0-82 points). The change score is calculated using the total scores of both the immediate and delayed portions.
Time Frame
Baseline, Week 48
Title
Change in Selective Reminding Test - Delayed Recall (SRT-DR)
Description
Change in Selective Reminding Test-Delayed Recall scores from baseline to Week 48: SRT Delay is administered 15 minutes after the immediate recall portion. Patients are asked to remember as many of the words as they can from the 6 trials. Maximum raw score is a 12 for free recall. If a patient is unable to recall a word, they are given a chance to recognize it among three incorrect word choices. Maximum raw score for recognition is 12. The greater the score on the delayed recall portion, the better the patient does on the assessment.
Time Frame
Baseline, Week 48
Title
Change in Trails B
Description
Change from baseline to Week 48 on Trails B: Measures attention and executive function. It asks patients to connect numbers and letters in numerical to alphabetical order from (1-13 and A-L) as fast as they can. Patients are timed; the longer it takes for the patient to connect the numbers and letters, the worse their score. Unit of measure is in seconds. The amount of errors that the patient makes during trails is also recorded.
Time Frame
Baseline, Week 48
Title
Change in Trails A
Description
Change in Trails A scores from baseline to Week 48: Measures attention and executive function. It asks patients to connect numbers from 1-25 in numerical order as fast as they can. Patients are timed; the longer it takes for the patient to connect the numbers, the worse their score. Unit of measure is in seconds. The amount of errors that the patient makes during trails is also recorded.
Time Frame
Baseline, Week 48
Other Pre-specified Outcome Measures:
Title
Change in 24-item HAMD
Description
Change in 24-item Hamilton Rating Scale for Depression (HAMD) scores from baseline to Week 48: HAMD measures depression severity based on a series of 24 items items. The range of HAMD total score is 0-74; 0 indicates no depressive symptoms and a maximum HAMD score is a 74, where the greater the score indicates more significant psychopathology. In this study, moderate to severe depression is considered a HAMD-24 greater than 14.
Time Frame
Baseline, Week 48
Title
Change in Treatment Emergent Side Effects (TESS)
Description
Somatic side effect rating scale which includes 26 common somatic side effects associated with previous medication clinical trials; rated by the study physician. Factors were dichotomized to "yes" or "no" responses on this scale, which equated to the symptom being either present or not present. "Yes" and "no" responses were given a value of 0 (no) or 1 (yes). Responses from the entire group were calculated and the mean at baseline and the last visit is reported below.
Time Frame
Baseline, Week 48
Title
Change in Clinical Global Impression - Depression Change
Description
The CGI Depression Change follows a seven-point likert scale. Compared to the patient's condition at baseline in the study [prior to medication initiation], the patient's condition is rated as: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. Responses were calculated for the entire group. Mean at final visit has been reported below. Higher mean at baseline indicates a decrease in depression scores.
Time Frame
Baseline, Week 48
Title
Change in Clinical Global Impression - Cognitive Change
Description
The CGI Cognitive Change follows a seven-point likert scale. Compared to the patient's condition at baseline in the study [prior to medication initiation], the patient's condition is rated as: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. Responses from the entire group were calculated. Mean at final visit and baseline is reported below.
Time Frame
Baseline, Week 48
Title
Conversion to Dementia Using Clinical Dementia Rating (CDR)
Description
The CDR is a numeric rating scale that is used to quantify the severity of one's cognitive function. The scale goes from 0=normal; 0.5=mild cognitive impairment; 1 to 3=mild to moderate/severe dementia. CDR was used a dichotomous outcome measure (no=0; yes=1).
Time Frame
Baseline, Week 48
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Of either sex, age greater than 49 years old
Meets criteria for both "depression" and "cognitive impairment".
Study Criteria for "depression":
i. Patients who meet DSM-IV criteria for Major Depression, Dysthymic Disorder, or Dysthymia symptoms criteria of minimum 6 month duration (not the 2 year DSM-IV criteria). ii. 24-item HAM-D greater than 13; and iii. Clinical Global Impression (CGI) for severity of Depression greater than 2 (absolute score at least mild to moderate depression on a 7-point scale)
Study Criteria for "cognitive deficit":
i. Subjective memory complaint ii.Mini Mental Status Exam (MMSE) greater than 24; and at least one of a, b, or c:
less than 3 on MMSE 5 min delay on recall
scores on 2 neuropsychological tests greater than 1 Standard Deviation (SD) below standardized norms, or
score on 1 neuropsychological tests greater than 2 SD below standardized norms.
Neuropsychological tests for inclusion criteria (subset of larger battery):
Selective Reminding Test with delay Wechsler Memory Scale (WMS): Visual Reproduction - with delay, % savings from immed to delay Controlled Oral Word Association Test Trails B Digit symbol subtest of Wechsler Adult Intelligence Scale (WAIS)-III Continuous Performance Test iii. CGI for severity of Cognitive deficit greater than 2 (absolute score on a 7-point scale:1=no deficit to 7=severe deficit). iv. Clinical Dementia Rating (CDR) = 0 or 0.5
Willing and capable of giving informed consent
Exclusion Criteria:
Meets Criteria for dementia (DSM-IV) or probable Alzheimer's disease by National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria (NINCDS-ADRDA criteria)
Meets criteria for:
schizophrenia
alcohol or substance dependence or abuse within the last 6 months.
Suicidal attempt in last 6 months or current suicidal intent.
Patients currently on an effective antidepressant medication
Use of cholinesterase inhibitors in the last year.
Neurological disease including stroke, epilepsy, or other neurodegenerative disorders.
An acute, severe or unstable medical condition such as metastatic or active cancer, hepatic disease, or primary renal disease requiring dialysis.
Patients who can not tolerate being tapered off antidepressant medication (i.e. greater than a 25% incr. in baseline HAM-D) or has a history indicating patient is unlikely to tolerate psychotropic washout.
Patient with a history of non-response to Citalopram or es-citalopram
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory Pelton, M.D.
Organizational Affiliation
New York State Psychiatric Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Davangere Devanand, M.D.
Organizational Affiliation
New York State Psychiatric Institute
Official's Role
Study Chair
Facility Information:
Facility Name
New York State Psychiatric Institute
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
8105707
Citation
Alexopoulos GS, Meyers BS, Young RC, Mattis S, Kakuma T. The course of geriatric depression with "reversible dementia": a controlled study. Am J Psychiatry. 1993 Nov;150(11):1693-9. doi: 10.1176/ajp.150.11.1693.
Results Reference
background
PubMed Identifier
18580597
Citation
Atri A, Shaughnessy LW, Locascio JJ, Growdon JH. Long-term course and effectiveness of combination therapy in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008 Jul-Sep;22(3):209-21. doi: 10.1097/WAD.0b013e31816653bc.
Results Reference
background
PubMed Identifier
18334761
Citation
Bakchine S, Loft H. Memantine treatment in patients with mild to moderate Alzheimer's disease: results of a randomised, double-blind, placebo-controlled 6-month study. J Alzheimers Dis. 2008 Feb;13(1):97-107. doi: 10.3233/jad-2008-13110.
Results Reference
background
PubMed Identifier
22566581
Citation
Barnes DE, Yaffe K, Byers AL, McCormick M, Schaefer C, Whitmer RA. Midlife vs late-life depressive symptoms and risk of dementia: differential effects for Alzheimer disease and vascular dementia. Arch Gen Psychiatry. 2012 May;69(5):493-8. doi: 10.1001/archgenpsychiatry.2011.1481.
Results Reference
background
PubMed Identifier
9862549
Citation
Bassuk SS, Berkman LF, Wypij D. Depressive symptomatology and incident cognitive decline in an elderly community sample. Arch Gen Psychiatry. 1998 Dec;55(12):1073-81. doi: 10.1001/archpsyc.55.12.1073.
Results Reference
background
PubMed Identifier
16894105
Citation
Boyle PA, Wilson RS, Aggarwal NT, Tang Y, Bennett DA. Mild cognitive impairment: risk of Alzheimer disease and rate of cognitive decline. Neurology. 2006 Aug 8;67(3):441-5. doi: 10.1212/01.wnl.0000228244.10416.20.
Results Reference
background
PubMed Identifier
7724692
Citation
Burt DB, Zembar MJ, Niederehe G. Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol Bull. 1995 Mar;117(2):285-305. doi: 10.1037/0033-2909.117.2.285.
Results Reference
background
PubMed Identifier
12860770
Citation
Charney DS, Reynolds CF 3rd, Lewis L, Lebowitz BD, Sunderland T, Alexopoulos GS, Blazer DG, Katz IR, Meyers BS, Arean PA, Borson S, Brown C, Bruce ML, Callahan CM, Charlson ME, Conwell Y, Cuthbert BN, Devanand DP, Gibson MJ, Gottlieb GL, Krishnan KR, Laden SK, Lyketsos CG, Mulsant BH, Niederehe G, Olin JT, Oslin DW, Pearson J, Persky T, Pollock BG, Raetzman S, Reynolds M, Salzman C, Schulz R, Schwenk TL, Scolnick E, Unutzer J, Weissman MM, Young RC; Depression and Bipolar Support Alliance. Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Arch Gen Psychiatry. 2003 Jul;60(7):664-72. doi: 10.1001/archpsyc.60.7.664.
Results Reference
background
PubMed Identifier
16720794
Citation
Chen X, Magnotta VA, Duff K, Boles Ponto LL, Schultz SK. Donepezil effects on cerebral blood flow in older adults with mild cognitive deficits. J Neuropsychiatry Clin Neurosci. 2006 Spring;18(2):178-85. doi: 10.1176/jnp.2006.18.2.178.
Results Reference
background
PubMed Identifier
19916207
Citation
Culang ME, Sneed JR, Keilp JG, Rutherford BR, Pelton GH, Devanand DP, Roose SP. Change in cognitive functioning following acute antidepressant treatment in late-life depression. Am J Geriatr Psychiatry. 2009 Oct;17(10):881-8. doi: 10.1097/jgp.0b013e3181b4bf4a.
Results Reference
background
PubMed Identifier
18723162
Citation
Devanand DP, Liu X, Tabert MH, Pradhaban G, Cuasay K, Bell K, de Leon MJ, Doty RL, Stern Y, Pelton GH. Combining early markers strongly predicts conversion from mild cognitive impairment to Alzheimer's disease. Biol Psychiatry. 2008 Nov 15;64(10):871-9. doi: 10.1016/j.biopsych.2008.06.020. Epub 2008 Aug 23.
Results Reference
background
PubMed Identifier
12571820
Citation
Devanand DP, Pelton GH, Marston K, Camacho Y, Roose SP, Stern Y, Sackeim HA. Sertraline treatment of elderly patients with depression and cognitive impairment. Int J Geriatr Psychiatry. 2003 Feb;18(2):123-30. doi: 10.1002/gps.802.
Results Reference
background
PubMed Identifier
8629893
Citation
Devanand DP, Sano M, Tang MX, Taylor S, Gurland BJ, Wilder D, Stern Y, Mayeux R. Depressed mood and the incidence of Alzheimer's disease in the elderly living in the community. Arch Gen Psychiatry. 1996 Feb;53(2):175-82. doi: 10.1001/archpsyc.1996.01830020093011.
Results Reference
background
PubMed Identifier
19176895
Citation
Doody RS, Ferris SH, Salloway S, Sun Y, Goldman R, Watkins WE, Xu Y, Murthy AK. Donepezil treatment of patients with MCI: a 48-week randomized, placebo-controlled trial. Neurology. 2009 May 5;72(18):1555-61. doi: 10.1212/01.wnl.0000344650.95823.03. Epub 2009 Jan 28.
Results Reference
background
PubMed Identifier
22689908
Citation
Farrimond LE, Roberts E, McShane R. Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review. BMJ Open. 2012 Jun 11;2(3):e000917. doi: 10.1136/bmjopen-2012-000917. Print 2012.
Results Reference
background
PubMed Identifier
17509485
Citation
Feldman HH, Ferris S, Winblad B, Sfikas N, Mancione L, He Y, Tekin S, Burns A, Cummings J, del Ser T, Inzitari D, Orgogozo JM, Sauer H, Scheltens P, Scarpini E, Herrmann N, Farlow M, Potkin S, Charles HC, Fox NC, Lane R. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol. 2007 Jun;6(6):501-12. doi: 10.1016/S1474-4422(07)70109-6. Erratum In: Lancet Neurol. 2007 Oct;6(10):849.
Results Reference
background
PubMed Identifier
17117395
Citation
Ferris S, Schneider L, Farmer M, Kay G, Crook T. A double-blind, placebo-controlled trial of memantine in age-associated memory impairment (memantine in AAMI). Int J Geriatr Psychiatry. 2007 May;22(5):448-55. doi: 10.1002/gps.1711.
Results Reference
background
PubMed Identifier
17242334
Citation
Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E, Krampla W, Tragl KH. Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology. 2007 Jan 23;68(4):288-91. doi: 10.1212/01.wnl.0000252358.03285.9d.
Results Reference
background
PubMed Identifier
17136705
Citation
Gabryelewicz T, Styczynska M, Luczywek E, Barczak A, Pfeffer A, Androsiuk W, Chodakowska-Zebrowska M, Wasiak B, Peplonska B, Barcikowska M. The rate of conversion of mild cognitive impairment to dementia: predictive role of depression. Int J Geriatr Psychiatry. 2007 Jun;22(6):563-7. doi: 10.1002/gps.1716.
Results Reference
background
PubMed Identifier
12756140
Citation
Green RC, Cupples LA, Kurz A, Auerbach S, Go R, Sadovnick D, Duara R, Kukull WA, Chui H, Edeki T, Griffith PA, Friedland RP, Bachman D, Farrer L. Depression as a risk factor for Alzheimer disease: the MIRAGE Study. Arch Neurol. 2003 May;60(5):753-9. doi: 10.1001/archneur.60.5.753.
Results Reference
background
PubMed Identifier
10690971
Citation
Grober E, Lipton RB, Hall C, Crystal H. Memory impairment on free and cued selective reminding predicts dementia. Neurology. 2000 Feb 22;54(4):827-32. doi: 10.1212/wnl.54.4.827.
Results Reference
background
PubMed Identifier
18651723
Citation
Houde M, Bergman H, Whitehead V, Chertkow H. A predictive depression pattern in mild cognitive impairment. Int J Geriatr Psychiatry. 2008 Oct;23(10):1028-33. doi: 10.1002/gps.2028.
Results Reference
background
PubMed Identifier
16273995
Citation
Koontz J, Baskys A. Effects of galantamine on working memory and global functioning in patients with mild cognitive impairment: a double-blind placebo-controlled study. Am J Alzheimers Dis Other Demen. 2005 Sep-Oct;20(5):295-302. doi: 10.1177/153331750502000502.
Results Reference
background
PubMed Identifier
12405546
Citation
Lange KL, Bondi MW, Salmon DP, Galasko D, Delis DC, Thomas RG, Thal LJ. Decline in verbal memory during preclinical Alzheimer's disease: examination of the effect of APOE genotype. J Int Neuropsychol Soc. 2002 Nov;8(7):943-55. doi: 10.1017/s1355617702870096.
Results Reference
background
PubMed Identifier
19204022
Citation
Lopez OL, Becker JT, Wahed AS, Saxton J, Sweet RA, Wolk DA, Klunk W, Dekosky ST. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry. 2009 Jun;80(6):600-7. doi: 10.1136/jnnp.2008.158964. Epub 2009 Feb 9. Erratum In: J Neurol Neurosurg Psychiatry. 2009 Sep 1;80(9):1056.
Results Reference
background
PubMed Identifier
19528519
Citation
Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL; Alzheimer's Disease Cooperative Study Group. Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology. 2009 Jun 16;72(24):2115-21. doi: 10.1212/WNL.0b013e3181aa52d3.
Results Reference
background
PubMed Identifier
18300306
Citation
Manly JJ, Tang MX, Schupf N, Stern Y, Vonsattel JP, Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol. 2008 Apr;63(4):494-506. doi: 10.1002/ana.21326.
Results Reference
background
PubMed Identifier
16625572
Citation
McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003154. doi: 10.1002/14651858.CD003154.pub5.
Results Reference
background
PubMed Identifier
15313849
Citation
Modrego PJ, Ferrandez J. Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: a prospective cohort study. Arch Neurol. 2004 Aug;61(8):1290-3. doi: 10.1001/archneur.61.8.1290.
Results Reference
background
PubMed Identifier
11255443
Citation
Morris JC, Storandt M, Miller JP, McKeel DW, Price JL, Rubin EH, Berg L. Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol. 2001 Mar;58(3):397-405. doi: 10.1001/archneur.58.3.397.
Results Reference
background
PubMed Identifier
20553766
Citation
Nyakas C, Granic I, Halmy LG, Banerjee P, Luiten PG. The basal forebrain cholinergic system in aging and dementia. Rescuing cholinergic neurons from neurotoxic amyloid-beta42 with memantine. Behav Brain Res. 2011 Aug 10;221(2):594-603. doi: 10.1016/j.bbr.2010.05.033. Epub 2010 May 27.
Results Reference
background
PubMed Identifier
16651510
Citation
Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry. 2006 May;63(5):530-8. doi: 10.1001/archpsyc.63.5.530.
Results Reference
background
PubMed Identifier
20164594
Citation
Palmer K, Di Iulio F, Varsi AE, Gianni W, Sancesario G, Caltagirone C, Spalletta G. Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. J Alzheimers Dis. 2010;20(1):175-83. doi: 10.3233/JAD-2010-1352.
Results Reference
background
PubMed Identifier
18088076
Citation
Pelton GH, Harper OL, Tabert MH, Sackeim HA, Scarmeas N, Roose SP, Devanand DP. Randomized double-blind placebo-controlled donepezil augmentation in antidepressant-treated elderly patients with depression and cognitive impairment: a pilot study. Int J Geriatr Psychiatry. 2008 Jul;23(7):670-6. doi: 10.1002/gps.1958.
Results Reference
background
PubMed Identifier
16861375
Citation
Peskind ER, Potkin SG, Pomara N, Ott BR, Graham SM, Olin JT, McDonald S. Memantine treatment in mild to moderate Alzheimer disease: a 24-week randomized, controlled trial. Am J Geriatr Psychiatry. 2006 Aug;14(8):704-15. doi: 10.1097/01.JGP.0000224350.82719.83.
Results Reference
background
PubMed Identifier
10190820
Citation
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999 Mar;56(3):303-8. doi: 10.1001/archneur.56.3.303. Erratum In: Arch Neurol 1999 Jun;56(6):760.
Results Reference
background
PubMed Identifier
15829527
Citation
Petersen RC, Thomas RG, Grundman M, Bennett D, Doody R, Ferris S, Galasko D, Jin S, Kaye J, Levey A, Pfeiffer E, Sano M, van Dyck CH, Thal LJ; Alzheimer's Disease Cooperative Study Group. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med. 2005 Jun 9;352(23):2379-88. doi: 10.1056/NEJMoa050151. Epub 2005 Apr 13.
Results Reference
background
PubMed Identifier
18288936
Citation
Porsteinsson AP, Grossberg GT, Mintzer J, Olin JT; Memantine MEM-MD-12 Study Group. Memantine treatment in patients with mild to moderate Alzheimer's disease already receiving a cholinesterase inhibitor: a randomized, double-blind, placebo-controlled trial. Curr Alzheimer Res. 2008 Feb;5(1):83-9. doi: 10.2174/156720508783884576.
Results Reference
background
PubMed Identifier
19903364
Citation
Ramakers IH, Visser PJ, Aalten P, Kester A, Jolles J, Verhey FR. Affective symptoms as predictors of Alzheimer's disease in subjects with mild cognitive impairment: a 10-year follow-up study. Psychol Med. 2010 Jul;40(7):1193-201. doi: 10.1017/S0033291709991577. Epub 2009 Nov 11.
Results Reference
background
PubMed Identifier
12672860
Citation
Reisberg B, Doody R, Stoffler A, Schmitt F, Ferris S, Mobius HJ; Memantine Study Group. Memantine in moderate-to-severe Alzheimer's disease. N Engl J Med. 2003 Apr 3;348(14):1333-41. doi: 10.1056/NEJMoa013128.
Results Reference
background
PubMed Identifier
21199965
Citation
Reynolds CF 3rd, Butters MA, Lopez O, Pollock BG, Dew MA, Mulsant BH, Lenze EJ, Holm M, Rogers JC, Mazumdar S, Houck PR, Begley A, Anderson S, Karp JF, Miller MD, Whyte EM, Stack J, Gildengers A, Szanto K, Bensasi S, Kaufer DI, Kamboh MI, DeKosky ST. Maintenance treatment of depression in old age: a randomized, double-blind, placebo-controlled evaluation of the efficacy and safety of donepezil combined with antidepressant pharmacotherapy. Arch Gen Psychiatry. 2011 Jan;68(1):51-60. doi: 10.1001/archgenpsychiatry.2010.184.
Results Reference
background
PubMed Identifier
11148233
Citation
Ritchie K, Artero S, Touchon J. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology. 2001 Jan 9;56(1):37-42. doi: 10.1212/wnl.56.1.37.
Results Reference
background
PubMed Identifier
22934752
Citation
Sachs-Ericsson N, Corsentino E, Moxley J, Hames JL, Rushing NC, Sawyer K, Joiner T, Selby EA, Zarit S, Gotlib IH, Steffens DC. A longitudinal study of differences in late- and early-onset geriatric depression: depressive symptoms and psychosocial, cognitive, and neurological functioning. Aging Ment Health. 2013;17(1):1-11. doi: 10.1080/13607863.2012.717253. Epub 2012 Aug 30.
Results Reference
background
PubMed Identifier
15326237
Citation
Salloway S, Ferris S, Kluger A, Goldman R, Griesing T, Kumar D, Richardson S; Donepezil 401 Study Group. Efficacy of donepezil in mild cognitive impairment: a randomized placebo-controlled trial. Neurology. 2004 Aug 24;63(4):651-7. doi: 10.1212/01.wnl.0000134664.80320.92.
Results Reference
background
PubMed Identifier
17588275
Citation
Steffens DC, Potter GG. Geriatric depression and cognitive impairment. Psychol Med. 2008 Feb;38(2):163-75. doi: 10.1017/S003329170700102X. Epub 2007 Jun 22.
Results Reference
background
PubMed Identifier
12177369
Citation
Wilson RS, Barnes LL, Mendes de Leon CF, Aggarwal NT, Schneider JS, Bach J, Pilat J, Beckett LA, Arnold SE, Evans DA, Bennett DA. Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology. 2002 Aug 13;59(3):364-70. doi: 10.1212/wnl.59.3.364.
Results Reference
background
PubMed Identifier
18322263
Citation
Winblad B, Gauthier S, Scinto L, Feldman H, Wilcock GK, Truyen L, Mayorga AJ, Wang D, Brashear HR, Nye JS; GAL-INT-11/18 Study Group. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology. 2008 May 27;70(22):2024-35. doi: 10.1212/01.wnl.0000303815.69777.26. Epub 2008 Mar 5. Erratum In: Neurology. 2010 Oct 19;75(16):1485.
Results Reference
background
PubMed Identifier
16390905
Citation
Zarate CA Jr, Singh JB, Quiroz JA, De Jesus G, Denicoff KK, Luckenbaugh DA, Manji HK, Charney DS. A double-blind, placebo-controlled study of memantine in the treatment of major depression. Am J Psychiatry. 2006 Jan;163(1):153-5. doi: 10.1176/appi.ajp.163.1.153.
Results Reference
background
PubMed Identifier
26559790
Citation
Pelton GH, Harper OL, Roose SP, Marder K, D'Antonio K, Devanand DP. Combined treatment with memantine/es-citalopram for older depressed patients with cognitive impairment: a pilot study. Int J Geriatr Psychiatry. 2016 Jun;31(6):648-55. doi: 10.1002/gps.4375. Epub 2015 Nov 11.
Results Reference
derived
Learn more about this trial
Memantine Plus Es-citalopram in Elderly Depressed Patients With Cognitive Impairment
We'll reach out to this number within 24 hrs