Nondrug Interventions Offer Meaningful Antidepressant Benefit in People with Dementia

Nondrug approaches are associated with a meaningful reduction in depressive symptoms in people with dementia, according to a study published online in The BMJ.

“Our systematic review and network meta-analysis showed that nondrug interventions were as, or more, efficacious than drug interventions for reducing symptoms of depression in people with dementia and without a diagnosis of a major depressive disorder,” researchers wrote. 

The review included 256 randomized trials comparing drug or nondrug interventions with usual care or other interventions for the treatment of depression in people with dementia. 

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No drug intervention alone was more effective than usual care, according to the study. However, 10 interventions were linked with a greater drop in depressive symptoms compared with usual care: cognitive stimulation, exercise, reminiscence therapy, cognitive stimulation with a cholinesterase inhibitor, massage and touch therapy, multidisciplinary care, psychotherapy combined with reminiscence therapy and environmental modification, occupational therapy, exercise combined with social interaction and cognitive stimulation, and animal therapy.

Furthermore, 3 interventions actually outperformed some drugs in reducing depressive symptoms in patients with dementia: massage and touch therapy, cognitive stimulation with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction.

“Intervention rankings suggest that nondrug interventions either alone or in combination with drug interventions are the best interventions for reducing symptoms of depression in people with dementia without a diagnosis of a major depressive disorder,” they wrote. “Our findings further suggest a high probability that people with dementia will derive a clinically meaningful benefit from nondrug interventions.”

—Jolynn Tumolo

References

Watt JA, Goodarzi Z, Veroniki AA, et al. Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis. The BMJ. 2021;372:n532.

Non-drug therapies as good as or better than drugs for treating depression in people with dementia [press release]. London, United Kingdom: BMJ; March 24, 2021.