title: Escitalopram versus risperidone for the treatment of behavioral and psychotic symptoms associated with Alzheimer's disease: a randomized double-blind pilot study.
abstract: BACKGROUND
  Antipsychotics are frequently used to treat psychosis, aggression and agitation in patients with Alzheimer's disease (AD), but safety warnings abound. Escitalopram was investigated since citalopram has demonstrated some effectiveness in AD. We compared escitalopram and risperidone for psychotic symptoms and agitation associated with AD.
  
  
  METHODS
  Inpatients with AD, who had been hospitalized because of behavioral symptoms, were recruited to a six-week randomized, double-blind, controlled trial. Participants (n = 40) were randomized to once daily risperidone 1 mg or escitalopram 10 mg.
  
  
  RESULTS
  The NPI total score improved in both groups. Onset was earlier in the risperidone-treated group, but improvement did not significantly differ between groups by study end. Completion rates differed for escitalopram (75%) and risperidone (55%), mainly due to adverse events. There were no adverse events in the escitalopram group, while in the risperidone group two patients suffered severe extrapyramidal symptoms and four patients suffered acute physical illness necessitating transfer to general hospital.
  
  
  CONCLUSIONS
  Escitalopram and risperidone did not differ in efficacy in reducing psychotic symptoms and agitation in patients with AD. Completion rates were higher for escitalopram-treated patients. Replication in larger trials with ambulatory patients is needed.
authors.affiliation: Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. mdybarak@gmail.com
authors.forename: Yoram
authors.initials: Y
authors.lastname: Barak
authors.forename: Igor
authors.initials: I
authors.lastname: Plopski
authors.forename: Shelly
authors.initials: S
authors.lastname: Tadger
authors.forename: Diana
authors.initials: D
authors.lastname: Paleacu
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D015283:Citalopram; D018967:Risperidone