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A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia
Pollock BG, Mulsant BH, Rosen J, Mazumdar S, Blakesley RE, Houck PR, Huber KA.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2007-09-10
Topic: Risk, prevention and care in population studies
Objective To compare citalopram and risperidone for the treatment of psychotic symptoms and agitation associated with dementia, with a priori hypotheses that risperidone would be more efficacious for psychosis and citalopram for agitation. Methods A 12-week randomized, controlled trial in nondepressed patients with dementia hospitalized because of behavioral symptoms (N = 103) was conducted at the University of Pittsburgh Medical Center. Participants were consecutively recruited on an inpatient unit if they had at least one moderate to severe target symptom (aggression, agitation, hostility, suspiciousness, hallucinations, or delusions). Once they improved sufficiently, they were discharged to nursing homes, personal care homes, or residential homes for continued treatment. Planned pre-post and mixed model analyses of the main outcome measures of Neurobehavioral Rating Scale and Side Effect Rating Scale at baseline and at weekly/biweekly intervals were conducted. Results Completion rates did not differ for citalopram and risperidone (overall completion rate: 44%). Agitation symptoms (aggression, agitation, or hostility) and psychotic symptoms (suspiciousness, hallucinations, or delusions) decreased in both treatment groups but the improvement did not differ significantly between the two groups. There was a significant increase in side effect burden with risperidone but not with citalopram such that the two groups differed significantly. Conclusion No statistical difference was found in the efficacy of citalopram and risperidone for the treatment of either agitation or psychotic symptoms in patients with dementia. These findings need to be replicated before citalopram or other serotonergic antidepressants can be recommended as alternatives to antipsychotics for the treatment of agitation or psychotic symptoms associated with dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Pollock, B. G., Mulsant, B. H., Rosen, J., Mazumdar, S., Blakesley, R. E., Houck, P. R., et al. (2007). A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1097/jgp.0b013e3180cc1ff5
Vancouver
Pollock BG, Mulsant BH, Rosen J, Mazumdar S, Blakesley RE, Houck PR, et al. A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2007. doi:10.1097/jgp.0b013e3180cc1ff5. PMID: 17846102.
BibTeX
@article{pollock2007-17846102,
author = {Pollock, B. G. and Mulsant, B. H. and Rosen, J. and Mazumdar, S. and Blakesley, R. E. and Houck, P. R. and Huber, K. A.},
title = {{A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2007},
doi = {10.1097/jgp.0b013e3180cc1ff5},
pmid = {17846102},
url = {https://doi.org/10.1097/jgp.0b013e3180cc1ff5}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Objective To compare citalopram and risperidone for the treatment of psychotic symptoms and agitation associated with dementia, with a priori hypotheses that risperidone would be more efficacious for psychosis and citalopram for agitation.
- Results Completion rates did not differ for citalopram and risperidone (overall completion rate: 44%).
- Agitation symptoms (aggression, agitation, or hostility) and psychotic symptoms (suspiciousness, hallucinations, or delusions) decreased in both treatment groups but the improvement did not differ significantly between the two groups.
- There was a significant increase in side effect burden with risperidone but not with citalopram such that the two groups differed significantly.
- These findings need to be replicated before citalopram or other serotonergic antidepressants can be recommended as alternatives to antipsychotics for the treatment of agitation or psychotic symptoms associated with dementia.
Why it matters
In 103 nondepressed people hospitalised with dementia and agitation or psychotic symptoms, this 12-week double-blind trial compared the antidepressant citalopram with the antipsychotic risperidone. Symptoms decreased in both groups with no significant difference between them, but side-effect burden rose significantly only with risperidone, and just 44% of participants completed the trial. The authors say the findings "need to be replicated" before citalopram can be recommended as an alternative to antipsychotics. There was no placebo group, and the trial does not address treating or preventing Alzheimer's itself.
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Study details
- Participants103
- Evidence strengthHigh
How this study scored 66/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 103 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 5 / 7 | Cited 258 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.3 citations a year over 21 year(s) since 2007 |
| Impact for its field and year | 4 / 6 | Cited 8.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Kimberly Huber: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17846102) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 66 / 100 | — |
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