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Serotonergic function and treatment of behavioral and psychological symptoms of frontotemporal dementia


Herrmann, Nathan, Black, Sandra E., Chow, Tiffany, Cappell, Jaclyn, Tang-Wai, David F., Lanctôt, Krista L.


The American Journal Of Geriatric Psychiatry: Official Journal Of The American Association For Geriatric Psychiatry, Volume: 20, No.: 9, Pages.: 789-797

Year of Publication



Objectives: The purposes of this study were first, to evaluate the effectiveness of citalopram in treating behavioral disturbances in frontotemporal dementia (FTD) subjects and second, to determine whether an association exists between serotonergic function, as determined by a neuroendocrine challenge, and treatment response.; Design: Single-dose citalopram (30 mg per os) challenge followed by a 6-week open-label study.; Setting: Outpatients referred to memory clinics.; Participants: Fifteen patients suffering from FTD with severe behavioral and psychological symptoms of dementia.; Intervention: Following citalopram challenge, all patients were treated with citalopram titrated to a target dose of 40 mg once daily.; Measurements: Behavioral disturbances, using the Neuropsychiatric Inventory (NPI) (primary outcome) and Frontal Behavioural Inventory (secondary outcome), were assessed. Change in prolactin concentration following citalopram challenge was used as an index of central serotonergic response.; Results: Citalopram treatment was effective in treating behavioral symptoms, with significant decreases in NPI total score (F[2, 28] = 6.644, p = 0.004), disinhibition (F[2, 28] = 4.030, p = 0.029), irritability (F[2, 28] = 7.497, p = 0.003) and depression (F[2, 28] = 3.467, p = 0.045) scores over the 6 weeks. Significant improvement in Frontal Behavioural Inventory scores suggested that citalopram was also effective in the treatment ofbehaviors specific to FTD. A lower change score in concentration of prolactin was significantly positively correlated with greater improvement in the total NPI score from baseline to endpoint (r = 0.687, p = 0.005). A blunted response to a citalopram challenge, implying a dysfunctional serotonergic system, predicted a more positive treatment outcome.; Conclusions: The results suggest that despite the endogenous serotonin deficiency of FTD, citalopram treatment may be effective in targeting the behavioral disturbances characteristic of FTD.;

Bibtex Citation

@article{Herrmann_2012, doi = {10.1097/jgp.0b013e31823033f3}, url = {}, year = 2012, month = {sep}, publisher = {Elsevier {BV}}, volume = {20}, number = {9}, pages = {789--797}, author = {Nathan Herrmann and Sandra E. Black and Tiffany Chow and Jaclyn Cappell and David F. Tang-Wai and Krista L. Lanct{^{o}}t}, title = {Serotonergic Function and Treatment of Behavioral and Psychological Symptoms of Frontotemporal Dementia}, journal = {The American Journal of Geriatric Psychiatry} }


adverse effects, aged, behavioral symptoms, biological markers, blood, citalopram, complications, diagnostic use, drug effects, drug therapy, female, frontotemporal dementia, humans, male, metabolism, methods, pituitary function tests, predictive value of tests, prolactin, psychology, serotonin uptake inhibitors, severity of illness index, therapeutic use

Countries of Study


Types of Dementia

Fronto Temporal (also known as Pick’s Disease)

Types of Study

Before and After Study

Type of Outcomes



Specialist Dementia Centre Care / Memory Clinic

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Antipsychotics and antidepressants