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A Controlled Clinical Trial of Sertraline in the Treatment of Depression in Nursing Home Patients With Late-Stage Alzheimer's Disease

Received December 3, 1998; revised February 10, 1999; accepted March 29, 1999. From the Department of Psychology, Long Island University, Brooklyn, NY. Address correspondence to Dr. Magai, Department of Psychology, Long Island University, 1 University Plaza, Brooklyn, NY 11201.

A sample of 31 female nursing home patients with late-stage Alzheimer's disease participated in a double-blind clinical trial of the antidepressant medication sertraline. Measures of depression included various objective scales and two measures of facial expressions of emotion coded during a semistructured interview using a facial affect coding system. Repeated-measures ANOVAs at baseline and at the 8-week endpoint indicated that on all measures, both the treatment and placebo groups improved over time, with three of six measures showing a significant time effect. The "knit-brow" facial measure approached significance for a Treatment x Time effect. Thus, sertraline had no significant benefits over placebo. However, if, as we hypothesize, the knit-brow response is more sensitive to signs of depression in advanced dementia, our study justifies the further investigation of the use of sertraline in this population.

Key Words: Sertraline • Long-Term Care • Depression • Alzheimer's Disease

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