Psychosis of Alzheimer disease: validity of the construct and response to risperidone.
OBJECTIVE
The authors evaluated the efficacy of risperidone in reducing psychotic and aggressive symptoms in a subgroup of patients who fulfilled operationalized criteria for psychosis of dementia.


METHODS
Authors conducted a subgroup analysis of patients in the risperidone database arising from a previous double-blind, randomized, placebo-controlled study. In the primary study, patients age 55 or older, with a DSM-IV diagnosis of Alzheimer disease and/or vascular dementia were randomized to placebo or 0.5 mg, 1.0 mg, or 2.0 mg/day of risperidone. For this analysis, patients were selected who fulfilled operationalized criteria for psychosis of dementia. These criteria were then validated. The primary outcome measures were the newly developed Psychosis and Aggression Severity Indices, derived from Parts 1 and 2 of the BEHAVE-AD rating scale.


RESULTS
At Week 12 and endpoint, patients with psychosis of dementia receiving 1 mg or 2 mg/day of risperidone showed significantly more improvement on the Psychosis Severity and Aggressiveness Severity Indices than those receiving placebo.


CONCLUSIONS
The construct of psychosis of dementia was validated, and the severity of both psychosis and aggressiveness was reduced with risperidone treatment in a robust and dose-related way, with a continuing response over the 12-week trial period.
Schneider
Lon S
LS
University of Southern California, Keck School of Medicine, Department of Psychiatry, Los Angeles, CA 90033, USA. sazen@usc.edu
Katz
Ira R
IR
Park
Sohee
S
Napolitano
Judy
J
Martinez
Rick A
RA
Azen
Stanley P
SP
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D015203:Reproducibility of Results; D018967:Risperidone / Q000008:administration & dosage / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents; D018967:Risperidone