Escitalopram for Delusion in an Oldest Old Patient with Alzheimer's Disease

Objective: To present a case of Alzheimer’s disease (AD) associated with delusions that were satisfactorily treated with escitalopram. Background: In Japan, there are currently no licensed medicines for the management of the behavioral and psychological symptoms of dementia (BPSD) in AD patients. Patient and Results: We present the case of an 88-year-old woman with AD who developed delusions that were successfully treated with escitalopram. We previously reported that anxiety in elderly AD patients was associated with delusions and hallucinations and was caused by disturbance of the serotonergic system. Therefore, we considered that enhancement of the serotonergic system may be useful for ameliorating delusion in the present AD patient. Escitalopram inhibits the reuptake of serotonin and experts allosteric potentiating actions on serotonin reuptake inhibitors, moreover, it has evidence of efficacy for treating affective symptoms in the old patients. Therefore, this agent may be useful for ameliorating serotonin deficiency and delusion in the oldest old AD patients. Conclusions: Escitalopram may be useful for the management of psychotic symptoms in relatively older patients with AD