Abstract | OBJECTIVE: DATA SOURCES: Literature searches were conducted using MEDLINE and EMBASE databases and clinicaltrials.gov. STUDY SELECTION: Overall, 55 articles were reviewed for inclusion. Several open-label studies and case reports were found on this topic, but only those involving both tacrine and use of the Neuropsychiatric Inventory were included. Regarding other drugs, only double-blind, placebo-controlled trials were selected for inclusion. DATA SYNTHESIS: CONCLUSION: The majority of patients with Alzheimer's disease will experience behavioral disturbances during the course of their disease. Atypical antipsychotics are used routinely in these situations to treat the psychotic features and agitation. However, atypicals now carry a "black box" warning issued by the Food and Drug Administration on the basis of evidence that their use in geriatric patients with dementia-related psychosis may put patients at increased risk of mortality as a result of cardiovascular or infectious events. An alternative to the atypicals may be the acetylcholinesterase inhibitors and memantine, which have been shown to stabilize cognitive as well as behavioral issues in patients, utilizing the "gold standard" for behavior, the Neuropsychiatric Inventory. Efficacy varies among agents, with the greatest positive effects seen with donepezil, which also has the greatest number of studies. Drug benefits were harder to demonstrate for mild-to-moderate BPSD compared with moderate-to-severe symptoms.
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Authors | Lisa J Miller |
Journal | The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
(Consult Pharm)
Vol. 22
Issue 9
Pg. 754-62
(Sep 2007)
ISSN: 0888-5109 [Print] United States |
PMID | 18198970
(Publication Type: Journal Article, Review)
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Chemical References |
- Antipsychotic Agents
- Cholinesterase Inhibitors
- Dopamine Agents
- Nootropic Agents
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Topics |
- Alzheimer Disease
(psychology)
- Antipsychotic Agents
(adverse effects, therapeutic use)
- Cholinesterase Inhibitors
(therapeutic use)
- Cognition Disorders
(drug therapy)
- Dopamine Agents
(therapeutic use)
- Humans
- Mental Disorders
(drug therapy)
- Nootropic Agents
(therapeutic use)
- Psychomotor Agitation
(drug therapy)
- Psychotic Disorders
(drug therapy)
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