Behavioral and psychological symptoms of dementia (BPSD) are common during the course of dementia and are associated with poor outcome for patients. There are some clinical data indicating that SSRI antidepressants have a positive influence on BPSD. Escitalopram has an excellent side-effect profile and might be a suitable treatment for BPSD in older demented patients.

An open-label observation of inpatients aged 65 to 90 years with a clinical diagnosis of probable AD and an MMSE score of 6 to 20 points and NPI total score ≥20 points treated with escitalopram for 8 weeks. The evaluation of improvement/worsening counted as ±10% change from baseline score in NPI and CMAI short. The results expressed in numbers of improved, unchanged and worsened patients.

13 patients, 12 women and 2 men. The average age was 79.3 years, the average MMSE was 12.8 points. Three patients discontinued due to AEs (bronchopneumonia, progressive worsening of dementia, transfer to another institution). The other AEs were mild and not related to study medication.

Most patients exhibited a reduction of BPSD, half of them with a very substantial reduction. Patients exhibited very good tolerance of the medication.