Effect of carbamazepine on agitation in Alzheimer's inpatients refractory to neuroleptics.
BACKGROUND
Agitation in Alzheimer's disease remains a principal problem in the clinical management of elderly patients. Neuroleptic medication appears to have modest efficacy in controlling behavioral symptoms in dementia patients. Carbamazepine has been reported to decrease agitation associated with various psychiatric disorders and to reduce neuroleptic side effects.


METHODS
In an open prospective study, the effects of carbamazepine on agitation, hostility, and uncooperativeness were investigated in 15 severely demented Alzheimer's inpatients who had failed to respond to prior treatment with neuroleptics. Depending on clinical efficacy and tolerability of carbamazepine treatment, concomitant medication with haloperidol was initiated. Severity of psychopathologic symptoms was assessed by the Brief Psychiatric Rating Scale during the study period of 4 weeks.


RESULTS
In 2 subjects, carbamazepine treatment was discontinued because of leukopenia and allergic reactions. A significant improvement in factor scores activation and hostility was observed after 4 weeks. Ten patients received concomitant medication with haloperidol.


CONCLUSIONS
Carbamazepine may be effective in treating agitation in severely demented Alzheimer's inpatients refractory to neuroleptic medication alone. The combination of carbamazepine and haloperidol seems to be promising in clinical management of elderly Alzheimer's patients.
Lemke
M R
MR
Department of Psychiatry, University of Duesseldorf, Ingolstadt Medical Center, Germany.
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006220:Haloperidol / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D002220:Carbamazepine; D006220:Haloperidol