One of dementia’s most challenging symptoms is increased agitation.
My dad passed away from dementia, so we all saw the sudden agitation, first-hand. Our normally placid father suddenly became extraordinarily anxious and difficult to manage.
And that’s really common for people suffering with dementia.
Doctors have options, but they often first turn to an antipsychotic like benzodiazepines. However, they sometimes come with significant risks for the elderly — particularly, falls. Falls lead to fractures, and fractures at that age, in that condition, can often send patients on a quick, downward spiral.
So quite a few doctors have turned to the antidepressant, mirtazapine (brand name: Remeron) in the hopes that it will help calm the extreme agitation without some of the negative effects of benzodiazepines.
The only problem?
A new study published in The Lancet suggests that mirtazapine doesn’t work for agitation in dementia.
In fact, it’s “possibly more likely to be associated with mortality than no intervention at all.”
In this particular study, researchers found that there were more deaths in the mirtazapine group than the control group, which got a sugar pill. However, the difference was only “marginally statistically significant.”
Meanwhile, there was no difference between the two groups in agitation and anxiety.
The researchers concluded that there’s no good reason to give mirtazapine to those suffering with dementia, and that it should “no longer [be] used to treat agitation in patients with dementia.“
Now, this blog is a pro-antidepressant space.
I’ve relied on antidepressants for years, and thank God for meds. Antidepressants can be a huge, life-changing and saving gift. And Christians are, unfortunately, often quick to use any study like this to condemn antidepressants, entirely.
But this study doesn’t have anything to do with patients who don’t have dementia, and take mirtazapine.
In fact, mirtazapine has proven extremely effective in treating depression and other conditions for many.
But if your loved one is suffering with agitation from dementia, it might be a good idea to show your doc this new study. Sometimes it can take awhile for the latest research to filter down.
Over at Harvard Health, Dr. Stephanie Collier has a tremendous read on the latest research on how to handle agitation in dementia patients.
According to research, “multidisciplinary care, massage and touch therapy, and music combined with massage and touch therapy” are superior to pharmacological treatments in handling agitation and anxiety in dementia patients.
Read Dr. Collier’s whole evidence-based-piece for some tips on how to incorporate multidisciplinary care.
Of course, every situation is different, but if you’re going through the enormous challenge of taking care of a loved one with dementia, it’s a good informational supplement.
