Olanzapine in the treatment of anxiety symptoms due to Alzheimer's disease: a post hoc analysis.
BACKGROUND
Alzheimer's disease (AD) is associated with both cognitive and behavioral symptoms. Agitation, hallucinations, delusions, aggression, irritability, and anxiety are observed in up to 90% of patients with dementia. Although new information has emerged in recent years on the treatment of psychosis and agitation in dementia, very little information is available about the treatment of anxiety symptoms in this population.


OBJECTIVE
To assess the efficacy and tolerability of olanzapine in the treatment of significant anxiety symptoms in patients with AD.


METHODS
A post hoc analysis of a previously published study was performed. Those post hoc analysis evaluated the response to treatment with olanzapine of a subgroup of AD patients presenting with significant symptoms of anxiety. Patients were considered to have significant symptoms of anxiety if their baseline in the Nursing home version of the Neuropsychiatric Instrument NPI/NH anxiety scores were > or = 2. The analysis included 120 patients.


RESULTS
Patients receiving olanzapine 5 mg/d were statistically significantly improved on the NPI/NH Anxiety item compared to those receiving placebo (olanzapine, 5 mg/d: -3.72; placebo: -1.67; p = 0.034). In the group of patients with clinically significant anxiety, somnolence was the only treatment-emergent event that was statistically different in any olanzapine treatment group compared with placebo (olanzapine 5 mg/d: 9 patients [25%], p = 0.034; 10 mg/d: 7 [23%], p = 0.054; 15 mg/d: 7 [26%], p = 0.050; placebo: 1 [3.7%]). When controlling for treatment-emergent somnolence, the improvement in anxiety in the olanzapine 5 mg/d group remained statistically significant (p = 0.049).


CONCLUSIONS
These findings suggest that olanzapine could be a safe and effective treatment for anxiety in Alzheimer's disease.
Mintzer
J
J
Medical University of South Carolina, Alzheimer's Research and Clinical Programs Charleston, SC 29406-6076, USA. mintzerj@musc.edu
Faison
W
W
Street
J S
JS
Sutton
V K
VK
Breier
A
A
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001569:Benzodiazepines; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009735:Nursing Homes; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome
D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine