Risperidone for behavioural symptoms in dementia

Risperidone is moderately effective for psychological and behavioural symptoms in patients with dementia, but it appears to increase extrapyramidal symptoms and somnolence, and may increase cerebrovascular adverse events.

A topic in Clinical Evidence summarizes the results of one systematic review including 2 RCTs with a total of 969 patients and one subsequent RCT with 167 patients. The patients had Alzheimer's disease, vascular dementia, or mixed dementia. Risperidone modestly but significantly improved behavioural and psychological symptoms over 12 weeks compared with placebo (Behave-AD scale -1.80, 95% CI -3.22 to -0.38 in the systematic review, -4.50, 95% CI -6.45 to -2.46 in the subsequent RCT). Risperidone was associated with increased extrapyramidal symptoms, somnolence and mild peripheral edema. Data from 4 RCTs including 1230 patients found that risperidone was associated with increase in cerebrovascular adverse events (29/764 (4%) compared to 7/466 (2%) with placebo) .

Ədəbiyyat

1. Warner J, Butler R, Arya P. What are the effects of treatments on behavioural and psychological symptoms in dementia? Clinical Evidence 2005;13:1227-1236.
2. Wooltorton E. Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials. CMAJ 2002 Nov 26;167(11):1269-70.