Gonadotrophin-releasing hormone agonist treatment of aggression in Alzheimer's disease: a case report.
No medication has received regulatory approval in the U.S.A. for the distressing agitation and aggressive behaviors that often complicate dementia. Although studies suggest that several psychotropic medications are sometimes useful for these behavioral problems, response is variable and adverse effects often limit treatment. Theoretical considerations suggest that increasing estrogenic activity or reducing androgenic activity could reduce agitation and aggression in dementia. Estrogen has been reported helpful for these symptoms, but adverse effects are problematic. Chronic administration of the synthetic gonadotropin (luteinising hormone) releasing hormone analogue, goserelin, reduces testosterone activity. Here we describe the apparently sustained elimination of previously treatment-resistant agitation and aggression with goserelin treatment in a 78-year-old male nursing-home resident with Alzheimer's disease.
Rosin
Richard A
RA
Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC), Seattle, WA 98108, USA. richard.rosin@med.va.gov
Raskind
Murray A
MA
D000368:Aged; D000374:Aggression / Q000187:drug effects* / Q000523:psychology; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D000588:Amines / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000627:therapeutic use; D000077206:Gabapentin; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D011433:Propranolol / Q000627:therapeutic use; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use; D013739:Testosterone / Q000097:blood; D014196:Trazodone / Q000627:therapeutic use; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D014150:Antipsychotic Agents; D003509:Cyclohexanecarboxylic Acids; D003987:Dibenzothiazepines; D017273:Goserelin; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D000077206:Gabapentin; D011433:Propranolol; D018967:Risperidone; D000077152:Olanzapine; D014196:Trazodone