Atypical antipsychotics for aggression and psychosis in Alzheimer's disease

Atypical antipsychotics are beneficial in the treatment of aggression, agitation and psychosis in people with Alzheimer's disease, but the risks of adverse events may outweigh the benefits, particularly with long term treatment.

A Cochrane review included 15 studies with a total of 5 574 participants. Only nine had sufficient data to contribute to a meta-analysis and only five have been published in full in peer reviewed journals. No trials of amisulpiride, sertindole or zotepine were identified which met the criteria for inclusion.

• There was a significant improvement in aggression with risperidone and olanzapine treatment compared to placebo.
• There was a significant improvement in psychosis amongst risperidone treated patients.
• Risperidone and olanzapine treated patients had a significantly higher incidence of serious adverse cerebrovascular events (including stroke), extrapyramidal side effects and other important adverse outcomes.
• There was a significant increase in drop-outs in risperidone (2 mg) and olanzapine (5–10 mg) treated patients.
• The data were insufficient to examine impact upon cognitive function.

Ədəbiyyat

1. Ballard C, Waite J. The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer's disease. Cochrane Database Syst Rev 2006 Jan 25;(1):CD003476.