SUMMARY

• Clinical studies designed to evaluate the efficacy and/or safety of SPRAVATO in patients with comorbid dementia have not been performed.
• Although not performed in patients with dementia, the SPRAVATO clinical program did measure cognition in patients with treatment-resistant depression using Cogstate and Hopkins Verbal Learning Test-Revised (HVLT-R) tests, and scores generally remained stable or slightly improved from baseline.^1-7 In the elderly subgroup (≥65 years of age) of 2 long-term safety trials, small increases of simple and choice reaction time occurred during the optimization/maintenance phase.^5,6
• A case report described an 84-year-old female patient with dementia, behavioral disorder, and cerebrovascular cognitive impairment who presented with an exacerbation of anxiety-depressive and behavioral disorders. A cerebral MRI revealed age-related homogeneous cortico-subcortical atrophy and stage Fazekas 3 vascular leukopathy. Additionally, the patient scored 17/30 on a Mini Mental Status Exam (MMSE) with a recall of 0/3 words, and with profound attention disorder in the context of her anxiety-depressive condition. SPRAVATO 28 mg was initiated twice weekly for 4 weeks in addition to continuing venlafaxine 75 mg and starting Ericksonian hypnosis.⁸ 
  • After 3 months, the patient demonstrated a significant reduction in anxiety-depressive symptoms and improvement in social interactions. Her MMSE remained stable (18/30) with an improvement in recall (2/3 words). Due to good neurocognitive and cardiovascular tolerance, a higher maintenance dose of SPRAVATO 56 mg was given at the 4th administration. The treatment was ongoing and administered regularly at the time of the report.

Literature Search

A literature search of MEDLINE^®, Embase^®, BIOSIS Previews^®, and Derwent Drug File and/or other resources, including internal/external databases) pertaining to this topic was conducted on 28 October 2024.