Olanzapine in dementia with Lewy bodies: a clinical study.
OBJECTIVE
Dementia with Lewy bodies (DLB) is now a well-recognized form of dementia in which psychosis and behavioural disturbance are common. Treatment with conventional neuroleptics is often very poorly tolerated. Olanzapine, a newly introduced atypical neuroleptic which binds to multiple receptor types with relatively low affinity for D2 receptors, may be a useful treatment option in DLB.


METHODS
The Behavioural Pathology in Alzheimer's Disease Rating Scale, The Neuropsychiatric Inventory, Unified Parkinson's Disease Rating Scale and The Webster Disability Scale.


METHODS
We present the results of eight DLB patients with associated psychotic and behavioural difficulties. All patients were given olanzapine 2.5-7.5 mg. Their psychotic phenomena and behavioural and extrapyramidal symptoms were monitored at 2-weekly intervals.


RESULTS
Three out of the eight patients could not tolerate olanzapine even at the lowest available dose. Two patients had clear improvement in psychotic and behavioural symptoms. Three patients were able to tolerate olanzapine but gained only minimal benefit.


CONCLUSIONS
Olanzapine at the doses used conferred little advantage over conventional neuroleptics and should only be given with great caution to patients with DLB. The utility of smaller doses deserves further evaluation.
University College London Medical School, Essex and Herts Community NHS Trust, UK.
Z
Z
Walker
J
J
Grace
R
R
Overshot
S
S
Satarasinghe
A
A
Swan
C L
CL
Katona
I G
IG
McKeith
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines; D003072:Cognition Disorders / Q000150:complications; D000075202:Contraindications; D003702:Delusions / Q000150:complications; D003704:Dementia / Q000150:complications / Q000188:drug therapy*; D003863:Depression / Q000150:complications; D004305:Dose-Response Relationship, Drug; D005260:Female; D006212:Hallucinations / Q000150:complications; D006801:Humans; D016631:Lewy Bodies; D008297:Male; D000077152:Olanzapine; D010300:Parkinson Disease / Q000150:complications; D010890:Pirenzepine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine