Gabapentin for the treatment of behavioural alterations in dementia: preliminary 15-month investigation.
BACKGROUND
Although the core feature of dementia is progressive cognitive disruption, non-cognitive behavioural problems are expressed in most patients with dementia during the course of their illness. While psychotropic drugs are frequently used to control behavioural symptoms, comorbidities, which are very common in the geriatric population, could often limit their use. Gabapentin may be a potential treatment in such situations.


METHODS
In this open, baseline comparison study 20 patients with probable Alzheimer's disease with behavioural alterations and serious comorbidities (paralytic ileus, open-angle glaucoma, ischaemic cardiopathy, hepatic failure or severe prostatic hyperplasia) received gabapentin for 15 months. Patients were allowed to continue any previous therapy for concurrent diseases. However, concomitant antipsychotic or benzodiazepine intake was not permitted.


RESULTS
Gabapentin appeared to be efficacious and well tolerated in this patient population, and did not appear to interact with other drugs. General benefit is reflected by a reduction of caregiver stress. No patients withdrew before the end of the study and no serious adverse events were reported.


CONCLUSIONS
The results of this study in patients with probable Alzheimer's disease with behavioural alterations and serious comorbidities indicate that gabapentin provides significant and sustained efficacy in terms of behaviour, with associated reductions in caregiver burden. The results of an ongoing larger, randomised, double-blind study of gabapentin are keenly awaited and may help to provide a safer and more efficacious treatment option for this group of patients.
Moretti
Rita
R
Dipartimento di Fisiologia e Patologia, Università degli Studi di Trieste, Trieste, Italy. moretti@univ.trieste.it
Torre
Paola
P
Antonello
Rodolfo M
RM
Cazzato
Giuseppe
G
Bava
Antonio
A
D000085:Acetates / Q000627:therapeutic use*; D000368:Aged; D000588:Amines; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003509:Cyclohexanecarboxylic Acids; D003704:Dementia / Q000150:complications*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D014151:Anti-Anxiety Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin