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Two recent studies have raised questions
about the efficacy and safety of atypical antipsychotics for
behavioural and psychological symptoms of dementia (BPSD). In
a randomized controlled trial (RCT) comparing risperidone to
placebo in nursing home residents with AD and psychosis, both
groups improved considerably with no significant differences
noted between placebo and risperidone (Mintzer et al
). In a meta-analysis of the atypical antipsychotic trials for
BPSD, Schneider et al examined data from 15 RCTs. While
there were statistically significant benefits in pooled results
from the aripiprazole (not available in Canada) and risperidone
trials, the authors question the clinical relevance of these
findings. They also noted increased adverse events, including
somnolence, urinary tract infections, cognitive decline and
cerebrovascular events.
Risperidone in the treatment of psychosis
of Alzheimer disease: results from a prospective clinical trial
(AM J GERIATR PSYCHIATRY 2006;14:280-291)
JACOBO MINTZER, MD,
ANDREW GREENSPAN, MD,
IVO CAERS, PhD,
ILSE VAn HOVE, MSc,
et al,
CHARLESTON, SC
Efficacy and adverse effects of atypical
antipsychotics for dementia: meta-analysis of randomized, placebo-controlled
trials
(AM J GERIATR PSYCHIATRY 2006;14:191-210)
LON S. SCHNEIDER, MD, MS,
KAREN DAGERMAN, MS,
PHILIP S. INSEL, MS
LOS ANGELES, CA
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