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Treating behavioral and psychological symptoms in patients with psychosis of Alzheimer's disease using risperidone

Published online by Cambridge University Press:  31 July 2006

Jonathan Rabinowitz ,
Ira Katz ,
Peter Paul De Deyn ,
Andrew Greenspan  and
Henry Brodaty
Jonathan Rabinowitz
Affiliation:
Bar Ilan University, Ramat Gan, Israel
Ira Katz
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Peter Paul De Deyn
Affiliation:
Department of Neurology, Memory Clinic, Middelheim Hospital, ZNA, and Laboratory of Neurochemistry and Behavior, Born Bunge Institute, Biomedical Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium
Andrew Greenspan
Affiliation:
Johnson & Johnson Pharmaceutical Research & Development, Titusville, NJ, USA
Henry Brodaty
Affiliation:
Academic Department for Old Age Psychiatry, University of New South Wales, Euroa Centre, Prince of Wales Hospital, Sydney, Australia
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Abstract

Objectives: To examine the effect of risperidone on specific behavioral and psychological symptoms of dementia (BPSD) among patients with psychosis of Alzheimer's disease (AD).

Methods: Post hoc exploratory analysis of data on 479 nursing-home patients with psychosis of AD from three 12-week, double-blind, placebo-controlled clinical trials. Criteria for psychosis of AD were a diagnosis of AD or mixed dementia and a rating of ≥ 2 on any delusion or hallucination item of the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale when entering the trial. Mean changes from baseline to endpoint were examined for items on the Cohen-Mansfield Agitation Inventory (CMAI) and BEHAVE- AD.

Results: On the CMAI, risperidone was significantly more effective than placebo in treating cursing or verbal aggression (p = 0.004), hitting (p < 0.001), performing repetitious mannerisms (p < 0.001), pacing, aimless wandering (p = 0.017), hoarding things (p = 0.02), hiding things (p = 0.02) and repetitive sentences or questions (p = 0.025). On the BEHAVE-AD, risperidone was significantly more effective than placebo in treating physical threats and/or violence (p = 0.001), agitation (other) (p = 0.001) and verbal outbursts (p = 0.026). Although analysis on individual hallucination and delusional items did not demonstrate specific responses, analyses of a composite of delusional items revealed significant drug-placebo differences.

Conclusions: These data indicate that risperidone is effective in treating a variety of symptoms associated with psychosis of AD.

Keywords

BPSDdementiaatypical antipsychoticsnursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 19 , Issue 2 , April 2007 , pp. 227 - 240
Copyright
International Psychogeriatric Association 2007

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