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. 2019 Sep 26;22(4):167–171. doi: 10.1136/ebmental-2019-300113

Table 1.

Main findings in the treatment of depression comorbid with dementia

Intervention Main findings
Pharmacological Monotherapy Antidepressants are not recommended for new-onset mild to moderate depression in those with dementia.
Dual therapy and augmentation Limited research evidence is available; some clinicians provide anecdotal evidence to support this strategy.
Monitoring of physical health With SSRIs, pay attention to the risks of hyponatraemia and GI bleeding.
Psychological Individual therapy There is some evidence for the effectiveness of cognitive–behavioural therapy and problem adaptation therapy.
Couple and family therapy There is little evidence for the efficacy of family and couples therapy.
Group therapy Some evidence for the effectiveness of group therapy, but substantial heterogeneity between studies.
Social Sleep hygiene Overall evidence does not support a significant treatment effect using sleep hygiene approaches.
Exercise Overall evidence does not support a significant positive impact of exercise on depressive symptoms.
Patient and carer education Relatively little work in this area and insufficient evidence to suggest patient and carer education is effective in reducing depressive symptoms.
Arts and museum attendance Music therapy has the best evidence and further work is needed to establish the benefits of other modalities.
Neurostimulation ECT Severe depression with comorbid dementia responds well to ECT and provides rapid resolution of symptoms.
TMS Limited literature on efficacy of TMS for treating and further studies are needed to evaluate its efficacy.

ECT, electroconvulsive therapy; GI, gastrointestinal; SSRIs, selective serotonin reuptake inhibitors; TMS, transcranial magnetic stimulation.