Effect of citalopram, a selective 5-HT reuptake blocker, in emotionally disturbed patients with dementia.

In patients with Alzheimer's disease and vascular dementia, there are symptoms not only of cognitive impairment but also of emotional disturbance. Postmortem human brain studies have shown a disturbed metabolism of serotonin and overactivity of neuroendocrine-controlling factors in the hypothalamus. Treatment with a selective 5-HT reuptake blocker, citalopram, causes a significant reduction in postdexamethasone cortisol levels. Citalopram in patients with dementia disorders produces no improvement in psychomotor and cognitive behavior, but symptoms of emotional disturbance are reduced. Citalopram does not have a pure antidepressant effect; rather, the drug is considered an emotional stabilizer.