Escitalopram for Agitation in Alzheimer Disease

摘要/项目总结 激越在阿尔茨海默病（AD）中很常见，是患者和护理人员的主要负担。 找到有效的治疗方法是当务之急。S-CitAD是一项安慰剂对照、随机试验， 艾司西酞普兰治疗12周对减少阿尔茨海默病患者激越的疗效 在美国和加拿大的25个研究中心进行了AD研究。在艾司西酞普兰治疗前， 护理人员给予心理社会干预，只有那些焦虑的病人没有 改善的被分配给药物治疗。病人的症状会对 提供给照顾者的心理社会干预强调了照顾者痛苦对 神经精神症状，特别是AD患者的激越。因此，表征 在看护者痛苦最有可能影响激越的情况下， 有价值的数据，以追求在未来的研究非药物干预的激越在AD。在 在本补充材料中，我们建议对S-CitAD护理人员进行电话采访，以检查 AD患者中照顾者苦恼与神经精神症状之间的相关性 具体来说，我们建议研究“COVID相关因素”的作用（即，个人感染，死亡 朋友或家庭成员、经济困难）、环境因素（即隔离程度， 州/省、获得医院病床的机会、平均家庭收入）、照顾者的痛苦，以及 S-CitAD参与者的神经精神症状。这些措施将补充 已经在S-CitAD中使用，从而丰富了S-CitAD试验的结果， 家长学习目标具体而言，本补充材料将允许对 与S-CitAD治疗的初始非药物阶段相关。

ABSTRACT/PROJECT SUMMARY FOR SUPPLEMENT Agitation is common in Alzheimer's disease (AD), and a major burden to patients and caregivers. Finding effective treatments is a priority. S-CitAD is a placebo-controlled, randomized trial investigating the efficacy of a 12-week treatment with escitalopram to reduce agitation in patients with Alzheimer's disease (AD) across 25 sites in the United States and Canada. Prior to treatment with escitalopram, caregivers are given a psychosocial intervention, and only those patients whose agitation is not improved are assigned to pharmacologic treatment. That patients' symptoms can respond to psychosocial intervention provided to caregivers underscores the influence of caregiver distress on neuropsychiatric symptoms, and agitation in particular, in patients with AD. Accordingly, characterizing the circumstances under which caregiver distress is most likely to affect agitation would provide valuable data to pursue in future studies of non-pharmacological interventions for agitation in AD. In this supplement, we propose to conduct a telephone interview with S-CitAD caregivers to examine the association between caregiver distress and neuropsychiatric symptoms in individuals with AD. Specifically, we propose to examine the role of “COVID-related factors” (i.e., personally infected, death of friend or family member, economic hardship), environmental factors (i.e. extent of quarantine by state/province, access to hospital beds, average household income), caregiver distress, and neuropsychiatric symptoms on S-CitAD participants. These measures will complement the measures already used in S-CitAD, and thereby enrich the findings of the S-CitAD trial within the scope of the parent study aims. Specifically, this supplement will allow for a penetrating examination of factors that bear relevance to the initial, non-pharmacological phase of S-CitAD treatment.