[Treatment of behavioral disorders in dementia with risperidone in psychogeriatric out-patients].
BACKGROUND
The atypical neuroleptic drug risperidone has been approved for the treatment of behavioural and psychological symptoms of dementia for more than three years in Germany. To assess the efficacy and tolerability of risperidone in general practice two open-label prospective studies were performed.


METHODS
In 7142 patients with dementia the treatment course with risperidone was examined over 6 resp. 8 weeks. Efficacy was evaluated by assessing the target symptoms agitation, aggression, sleep-wake-cycle disturbances, social withdrawal, suspiciousness, and delusion. Furthermore, the global impression was rated by the physician and the caregiver at the end of the study. The tolerability of risperidone was documented by monitoring blood pressure, heart rate, bodyweight, and adverse events.


RESULTS
6170 patients complied with the inclusion criteria for analysis. Risperidone achieved statistically significant improvements of behavioural symptoms at an average dose of 1,5 mg/d (90% of patients received < or = 2 mg/d). 92% of the patients showed a favourable treatment response as defined by a > or = 30% improvement of the total score of the target symptoms. This improvement was already apparent 2 and 3 weeks after the start of treatment, respectively. A subgroup analysis demonstrated statistically significant improvements of target symptoms with risperidone also in patients who had been pre-treated with other neuroleptics. The global impression of physician and caregiver was positive in over 90% of patients. Adverse events were seen in 309 of 6170 patients (5,7%).


CONCLUSIONS
Risperidone was highly effective and well tolerated in the treatment of behavioural disturbances in dementia under routine conditions of general practice.
Kurz
A
A
Technische Universität München, Psychiatrische Klinik. alexander.kurz@lrz.tum.de
Delius-Stute
H
H
Rettig
K
K
Schwalen
S
S
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002090:Butyrophenones / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015140:Dementia, Vascular / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy*; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D018967:Risperidone / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D002090:Butyrophenones; C008522:metylperon; D018967:Risperidone