Reimaging the Approach to Treating Alzheimer Agitation: Sube Banerjee, MD, MSc, MBA, FRCPsych


The professor of dementia and executive dean of the Faculty of Health at the University of Plymouth provided perspective on the way to attack Alzheimer agitation and why drug solutions often fall short. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"If you think about the things that cause agitation, it’s a very broad and complex group of things that are about social adaptation, the reaction of people to the memory problems they have, and the reaction of others to people with dementia. Very little of that is likely to be treatable with [just] medication."

With no FDA-approved therapies currently available, treating the symptoms of agitation remains among the greatest unmet needs for patients with Alzheimer disease (AD) and their caregivers. While there are several pharmaceutical companies attempting to solve this problem with a single drug approach, treating the roots of agitation requires more complex approaches, says Sube Banerjee, MD, MSc, MBA, FRCPsych.

Banerjee, a professor of dementia and executive dean of the Faculty of Health at the University of Plymouth, recently presented work at the 2022 Clinical Trials on Alzheimer Disease (CTAD) conference, November 29 to December 2, in San Francisco, California, on the effectiveness of commonly used agents to treat AD agitation. Otherwise known as the SYMBAD trial (NCT03031184), the study assessed the safety, clinical and cost effectiveness of martazpine, an antidepressant, and carbamazepine, an anticonvulsant, in the treatment of AD agitation using change in Cohen Mansfield Agitation Inventory scores as the primary outcome.

At the end of a 12-week treatment period, the results suggested that mirtazapine is not clinically effective or cost-effective for clinically significant agitation in dementia. The data also provided no signal that carbamazepine might have any positive effect on agitation above that seen in the placebo group and no evidence of long-term benefit of either drug. At CTAD 2022, Banerjee sat down with NeurologyLive® to discuss the implications of these findings, and the need to think outside-the-box when it comes to treating AD agitation. Additionally, he stressed the need for a rounded approach to the symptom, noting that medications don’t necessarily treat the social aspects that exasperate a patient’s condition.

Click here for more coverage of CTAD 2022.

1. Banerjee S, Symbad group. Long-term and economic outcomes for mirtazapine and carbamazepine vs placebo: new data from the SYMBAD RCT. Presented at: 2022 CTAD Conference; November 29-December 2; San Francisco, CA. OC05.
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