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Effect of Low-dose Escitalopram on Cognition and Behavior of Patients With Dementia Without Depression: A Retrospective Study

Clin Neuropharmacol. 2026 Feb 16. doi: 10.1097/WNF.0000000000000675. Online ahead of print.

ABSTRACT

OBJECTIVE: The role of escitalopram on cognition in patients with dementia is inconclusive. In this study effect of low-dose escitalopram on cognition in subjects with dementia without depression is explored.

METHODS: This is a retrospective study of subjects aged 60 years or more with a diagnosis of dementia without depression conducted in a tertiary-care hospital in India. Subjects treated with low-dose escitalopram with a follow-up of 12 weeks duration were included. The parameters extracted were sociodemographic characteristics, duration and type of dementia, comorbidities, other psychotropics, and antidementia drugs. The change in Hindi Mental Status Examination score from baseline to fourth, eighth, and 12th weeks is considered the primary outcome measure. In addition, changes in neuropsychiatric symptoms are the secondary outcome measures. Statistical methods include descriptive and comparative analysis, and repeated measures ANOVA was applied to assess change in cognition over time.

RESULTS: A total of 44 subjects were included, with a mean age of 73.5 ± 7.42 years and 56.82%. Among the subjects, 79.55% were diagnosed with AD, 11.36% with FTD, and 9.09% with VD, and the average duration of illness was 4.48 ± 2.28 years. Comparison of HMSE score from baseline to fourth, eighth, and 12th week shows a significant difference with P <0.001, with greater improvement in the first 4 weeks. In addition, the NPI and ADL scores showed significant improvement in week-4 with P <0.001.

CONCLUSION: Escitalopram shows a promising effect on cognition, behaviour, and functionality in subjects with dementia in the short term. However, a larger prospective long-term study is needed to validate the study findings.

PMID:41805243 | DOI:10.1097/WNF.0000000000000675

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