Clinical experience with risperidone in the treatment of behavioral and psychological symptoms of dementia.
Dementia is a neuropsychiatric disorder characterized by cognitive impairment and behavioral and psychological symptoms. The efficacy and tolerability of risperidone for treating dementia-associated psychological and behavioral disturbances were evaluated in a study of 135 patients aged 60-85 years with DSM-IV diagnoses of Alzheimer's disease. All were treated with risperidone at a starting dose of 0.5 mg once daily at bedtime. After the first 3 days of therapy the dosage was increased to 1 mg in 2 doses (morning and evening), then a further 0.5 mg was added (alternatively in the morning and in the evening) every three days until attenuation of the psychiatric symptoms. The response to treatment was evaluated for a period of 12 weeks by the Neuropsychiatric Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Both NPI and BEHAVE-AD were administered at the baseline visit, and after 4 and 12 weeks of therapy. Tolerability was assessed by the incidence of clinically evident side effects. The mean dose at endpoint was 1 mg/day of risperidone. The mean NPI score was 28.80+/-13.92 at start, 15.55+/-11.25 after 4 weeks and 8.30+/-7.00 at endpoint. The reduction in mean scores at 4 and 12 weeks was statistically significant in most of the Neuropsychiatric Inventory items, except for appetite disorders (p<0.0001). The mean BEHAVE-AD score was 20.44+/-3.92 at start, 13.50+/-11.39 after 4 weeks and 8.03+/-7.80 at endpoint. All the items showed a statistically significant improvement after 4 and 12 weeks (p<0.0001). The results were better at 12 than at 4 weeks. In our elderly patients with dementia low-dose risperidone was well tolerated and associated with reductions in BPSD, in particular agitation, aggression, irritability, delusions, sleep disorders, anxiety and phobias.
Onor
Maria Luisa
ML
Department of Clinical, Morphological and Technological Sciences, U.O.C. of Clinical Psychiatry, University of Trieste, Via de Ralli n. 5, Trieste, Italy. marialuisa.onor@libero.it
Saina
Marisa
M
Trevisiol
Marianna
M
Cristante
Tania
T
Aguglia
Eugenio
E
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001519:Behavior / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D018967:Risperidone