Trial reportThe American journal of psychiatry2016
Effects of Citalopram on Neuropsychiatric Symptoms in Alzheimer's Dementia: Evidence From the CitAD Study.
Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in The American journal of psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 pooled it
7.5field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Pharmacological and Non-Pharmacological Interventions to Improve Sleep in People with Cognitive Impairment: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2025Pooled it
- Treatment of apathy in stroke patients: a systematic review.Frontiers in neurology · 2025Pooled it
- Pharmacological interventions for apathy in Alzheimer's disease.The Cochrane database of systematic reviews · 2018Pooled it
- What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys.PloS one · 2018Pooled it
- Neuropsychiatric symptoms in Alzheimer's disease: Bridging mechanisms, management, and emerging innovations.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Review
- Recommendations for management and future investigation of psychosis in neurodegenerative disease: Findings from the International Psychogeriatric Association (IPA) working group.International psychogeriatrics · 2025Review
- Factors associated with length of stay in patients from residential aged care facilities admitted for behavioural and psychological symptoms of dementia.Australasian journal on ageing · 2025Article
- Emerging Pharmacological Approaches for Psychosis and Agitation in Alzheimer's Disease.CNS drugs · 2025Review
- Cerebellum in Alzheimer's disease and other neurodegenerative diseases: an emerging research frontier.MedComm · 2024Review
- Unique transcriptional signatures correlate with behavioral and psychological symptom domains in Alzheimer's disease.Translational psychiatry · 2024Article
- Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review.Journal of geriatric psychiatry and neurology · 2023Review
- An Update on Apathy in Alzheimer's Disease.Geriatrics (Basel, Switzerland) · 2023Review
- The Effect of Agomelatine in Behavioral and Psychological Symptoms of Dementia.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2022Article
- Alzheimer's Disease: Challenges and a Therapeutic Opportunity to Treat It with a Neurotrophic Compound.Biomolecules · 2022Review
- A Narrative Review of Studies Comparing Efficacy and Safety of Citalopram with Atypical Antipsychotics for Agitation in Behavioral and Psychological Symptoms of Dementia (BPSD).Pharmacy (Basel, Switzerland) · 2022Review
- Novel Therapeutic Target for Prevention of Neurodegenerative Diseases: Modulation of Neuroinflammation with Sig-1R Ligands.Biomolecules · 2022Review
- Pharmacological Management of Apathy in Dementia.CNS drugs · 2022Review
- Emotional and Neuropsychiatric Disorders Associated with Alzheimer's Disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Review
- Association Between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in the Treatment of Depression in Patients with Alzheimer's Disease.Journal of Alzheimer's disease reports · 2022Article
- The Development of Pharmacological Therapies for Alzheimer's Disease.Neurology and therapy · 2021Review
Corrections and comments
- Commented on by
Authors and funding
18 authors at 1 institution in 1 country.
Anne K LeonpacherFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Matthew E PetersFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Lea T DryeFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Kelly M MakinoFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Jeffery A NewellFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
D P DevanandFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Constantine FrangakisFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Cynthia A MunroFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Jacobo E MintzerFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Bruce G PollockFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Paul B RosenbergFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Lon S SchneiderFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
David M ShadeFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Daniel WeintraubFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Jerome YesavageFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Constantine G LyketsosFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Anton P PorsteinssonFrom the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; the Johns Hopkins Bloomberg School of Public Health, Baltimore; the Alzheimer's Disease Care, Research, and Education Program, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.; the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford; the Division of Geriatric Psychiatry, Department of Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York; the Clinical Biotechnology Research Institute, Roper St. Francis Healthcare, and the Department of Psychiatry, Ralph H. Johnson VA Medical Center, Charleston, S.C.; the Campbell Institute, Centre for Addiction and Mental Health, and the Department of Psychiatry, University of Toronto, Toronto; the Department of Psychiatry and Behavioral Sciences and the Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles; and the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
CitAD Research Group
Johns Hopkins University · US
Funding
Citalopram Treatment for Agitation in Alzheimer DementiaR01AG031348 · NIA · JOHNS HOPKINS UNIVERSITY · PI LYKETSOS, CONSTANTINE G · 2008 to 2012
$7.9MNIA NIH HHS R01 AG031348
Abstract
objectiveCitalopram has been shown to improve agitation in patients with Alzheimer's disease. The authors evaluated whether other neuropsychiatric symptoms improve with citalopram treatment compared with placebo.
methodIn this planned secondary analysis of the Citalopram for Agitation in Alzheimer's Disease study, the authors evaluated the effect of citalopram on the 12 neuropsychiatric symptom domains assessed by the Neuropsychiatric Inventory (NPI). They compared caregiver-reported NPI scores at week 9 in patients receiving citalopram (30 mg/day) or placebo with regard to both the presence or absence of individual neuropsychiatric symptoms and individual domain scores (reflecting severity) in participants who had symptoms at week 9.
resultsAt week 9, participants treated with citalopram were significantly less likely to be reported as showing delusions (odds ratio=0.40), anxiety (odds ratio=0.43), and irritability/lability (odds ratio=0.38). A comparison of median scores of participants with symptoms present at week 9 showed significant differences favoring citalopram for hallucinations and favoring placebo for sleep/nighttime behavior disorders.
conclusionsWhile dosage constraints must be considered because of citalopram's adverse effect profile, this agent's overall therapeutic effects in patients with Alzheimer's disease and agitation, in addition to efficacy for agitation/aggression, included reductions in the frequency of irritability, anxiety, and delusions; among patients who had these symptoms at week 9, they included a reduction in the severity of hallucinations but an increase in the severity of sleep/nighttime behavior disorders.
Indexed as
Alzheimer DiseaseAntidepressive Agents, Second-GenerationAnxietyCitalopramDelusionsFemaleHallucinationsHumansIrritable MoodMaleSleep Wake DisordersAntidepressive Agents, Second-GenerationCitalopram
Identifiers
What OpenQuestion holds
Textmetadata
Read underepoch 390
Registered trials
None linked
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.