Alprazolam as an alternative to low-dose haloperidol in older, cognitively impaired nursing facility patients.
OBJECTIVE
To determine if alprazolam is equally as effective as low dose haloperidol in managing disruptive behavioral episodes associated with delirium, dementia, and amnesic and other cognitive disorders (formerly called organic mental syndromes).


METHODS
Twenty-five community nursing homes in western Washington.


METHODS
Older nursing home residents (N = 48) receiving a low-dose neuroleptic for the treatment of agitation and behavioral disturbances.


METHODS
Randomized, double-blind, crossover trial of alprazolam and low dose haloperidol. Data were gathered at baseline and at the end of 6 and 12 weeks from direct observation and from clinical forms completed routinely by trained nurses.


METHODS
Number of behavioral episodes, activities of daily living as measured by the Blessed Dementia Scale, extrapyramidal symptoms as measured by the Abnormal Involuntary Movement Scale (AIMS), and psychopathology as measured by the Clinical Global Impressions (CGI) and the Sandoz Clinical Assessment - Geriatric (SCAG) scales.


CONCLUSIONS
No significant differences were observed between patients using haloperidol or alprazolam in terms of behavioral episodes per week. Further, with few exceptions, no significant differences were found in other outcome scales. Essentially the same findings were found when analyses were repeated for subgroups of patients with high levels of cognitive impairment and for patients with low and high levels of recorded problematic behavioral episodes. Alprazolam was as effective as low dose haloperidol in this population.
Christensen
D B
DB
Department of Pharmacy, University of Washington, Seattle 98195-7630, USA.
Benfield
W R
WR
D000368:Aged; D000369:Aged, 80 and over; D000525:Alprazolam / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001526:Behavioral Symptoms / Q000188:drug therapy; D003072:Cognition Disorders / Q000188:drug therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009735:Nursing Homes
D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D006220:Haloperidol; D000525:Alprazolam