title: Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia: an open randomized trial.
abstract: OBJECTIVE
  To examine the effects of galantamine and risperidone on neuropsychiatric symptoms in dementia (NPSD) and global function.
  
  
  METHODS
  Using a randomized, controlled and open-blind, one-center trial at an in- and outpatient clinic at a university hospital, we studied 100 adults with probable dementia and NPSD. Participants received galantamine (N = 50, target dose 24 mg) or risperidone (N = 50, target dose 1.5 mg) for 12 weeks. The primary outcome was effects on NPSD assessed by the Neuropsychiatric Inventory (NPI). Secondary measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Clinical Global Impression, and Simpson Angus scales. All tests were performed before and after treatment.
  
  
  RESULTS
  Outcome measures were analyzed using analysis of covariance. Ninety-one patients (67% women, mean age 79 ± 7.5 years) with initial NPI score of 51.0 (± 25.8) and MMSE of 20.1 (± 4.6) completed the trial. Both galantamine and risperidone treatments resulted in improved NPSD symptoms and were equally effective in treating several NPI domains. However, risperidone showed a significant treatment advantage in the NPI domains irritation and agitation, F(1, 97) = 5.2, p = 0.02. Galantamine treatment also ameliorated cognitive functions where MMSE scores increased 2.8 points compared with baseline (95% confidence interval: 1.96-3.52). No treatment-related severe side effects occurred.
  
  
  CONCLUSIONS
  These results support that galantamine, with its benign safety profile, can be used as first-line treatment of NPSD symptoms, unless symptoms of irritation and agitation are prominent, where risperidone is more efficient.
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden. Electronic address: Yvonne.Freund-Levi@ki.se.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Freund-Levi
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Jedenius
authors.affiliation: Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Ann Christine
authors.initials: AC
authors.lastname: Tysen-Bäckström
authors.affiliation: Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Lärksäter
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Eriksdotter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005702:Galantamine / Q000627:therapeutic use*; D006801:Humans; D007508:Irritable Mood; D008297:Male; D009483:Neuropsychological Tests; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D002800:Cholinesterase Inhibitors; D005702:Galantamine; D018967:Risperidone
keywords: NPI; NPSD; Neuropsychiatric symptoms; dementia; galantamine; risperidone