title: Long-term efficacy of olanzapine in the control of psychotic and behavioral symptoms in nursing home patients with Alzheimer's dementia.
abstract: BACKGROUND
  Psychotic symptoms and behavioral disturbances are a leading cause of institutionalization in elderly patients with Alzheimer's disease (AD).
  
  
  OBJECTIVE
  Elderly nursing home patients (n=105) with possible or probable AD were entered into a multicenter study to determine the long-term efficacy and safety of olanzapine in treatment of psychotic symptoms and behavioral disturbances due to AD.
  
  
  METHODS
  Following a double-blind, 6-week exposure to fixed-dose olanzapine (5, 10, or 15 mg/d), patients entered an additional 18-week, open-label, flexible-dose treatment. Baseline was defined from the start of the extension phase.
  
  
  RESULTS
  Patients improved significantly on the primary efficacy measure, defined a priori, which consisted of the sum of the Agitation/Aggression, Delusions, and Hallucinations items ('Core':) of the NPI/NH. Olanzapine also significantly improved scores for the NPI/NH total and the Core item-associated Occupational Disruptiveness of the NPI/NH, as well as the BPRS total and CGI Severity-of-Alzheimer's scores. Barnes Akathasia scores improved significantly from baseline, while Simpson-Angus and AIMS scores were not significantly changed. Treatment-emergent symptoms included somnolence, accidental injury, and rash. No significant changes were seen in ECGs, including QT(c) interval, nor in weight or vital signs, including orthostasis.
  
  
  CONCLUSIONS
  Low-dose olanzapine appears to be effective and well tolerated for treatment of behavioral disturbances and psychotic symptoms due to AD in elderly patients.
authors.affiliation: Lilly Research Laboratories, Indianapolis, IN 46285, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Street
authors.forename: W S
authors.initials: WS
authors.lastname: Clark
authors.forename: D L
authors.initials: DL
authors.lastname: Kadam
authors.forename: S J
authors.initials: SJ
authors.lastname: Mitan
authors.forename: B E
authors.initials: BE
authors.lastname: Juliar
authors.forename: P D
authors.initials: PD
authors.lastname: Feldman
authors.forename: A
authors.initials: A
authors.lastname: Breier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001526:Behavioral Symptoms / 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; D008134:Long-Term Care; D008297:Male; D009483:Neuropsychological Tests; D009735:Nursing Homes; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine