Antipsychotics for agitation and psychosis in people with Alzheimer's disease and vascular dementia

Mühlbauer, Viktoria; Luijendijk, Hendrika J.; Dichter, Martin N.; Mohler, R. Albert; Zuidema, Sytse U.; Köpke, Sascha

doi:10.1002/14651858.cd013304

Cited by 22 publications

(24 citation statements)

References 41 publications

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“…e reason may be that donepezil hydrochloride regulates the hydrolysis of acetylcholine ester in the central neurons, boosts the level of acetylcholine in brain tissue, and alleviates memory loss and mental agitation in Alzheimer's disease patients [24]. Moreover, the patients in the present study received TCM adjuvant therapy.…”

Section: Discussionmentioning

confidence: 86%

Efficacy of Donepezil Hydrochloride plus Olanzapine for Senile Dementia and Its Effect on the Recovery of Cognitive Function

Zheng

Sun

Liu

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the efficacy of donepezil hydrochloride plus olanzapine for senile dementia and its effect on the recovery of cognitive function. Methods. A total of 60 patients with senile dementia admitted to our hospital from April 2020 to July 2021 were recruited and assigned to receive either olanzapine alone (observation group) or donepezil hydrochloride plus olanzapine (experimental group) via the random number table method, with 30 patients in each group. Results. The combined therapy resulted in significantly higher clinical efficacy versus monotherapy of olanzapine ( P < 0.05 ). Before treatment, the difference in the scores of cognitive function between the two groups did not come up to the statistical standard ( P > 0.05 ). Donepezil hydrochloride plus olanzapine was associated with significantly higher scores of cognitive function in patients versus olanzapine alone ( P < 0.05 ). The two groups had a similar incidence of adverse reactions ( P > 0.05 ). Conclusion. Donepezil hydrochloride plus olanzapine substantially enhances the recovery of cognitive function of patients with senile dementia and features a manageable safety. Further trials are, however, required prior to clinical promotion.

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Section: Discussionmentioning

confidence: 86%

Efficacy of Donepezil Hydrochloride plus Olanzapine for Senile Dementia and Its Effect on the Recovery of Cognitive Function

Zheng

Sun

Liu

2022

Evidence-Based Complementary and Alternative Medicine

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“…Olanzapine and risperidone are the main atypical antipsychotic drugs. Randomized trials comparing olanzapine and risperidone directly show that olanzapine is more effective than risperidone, and its safety is higher [ 13 ]. However, there exhibits no remarkable difference in the therapeutic effect between olanzapine and risperidone, but olanzapine takes effect faster and the incidence of extrapyramidal symptoms is lower [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis of the Efficacy and Safety of Olanzapine versus Clozapine when Treating Senile Dementia

Wang

Yang

Wang

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To systematically assess the safety and efficacy of olanzapine versus clozapine when treating senile dementia and to provide evidence-based medicine basis for its promotion and use. Methods. PubMed, Embase, ScienceDirect, Cochrane Library, China Knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database were searched for randomized controlled trials (RCT) of olanzapine and clozapine when treating senile dementia. The retrieval time limit is from the establishment of the database to the present. The data were extracted independently by two researchers, and the bias risk of each contained literature was analyzed in accordance with the standard of Cochrane Handbook 5.3. RevMan 5.4 statistical software was used to analyze the collected data by meta-analysis. Results. Finally, 6 randomized controlled trial articles were included, with a total of 490 samples. Meta-analysis of clinical efficacy showed that the clinical efficacy was similar and there was no significant difference ( P > 0.05 ). Two articles used Alzheimer’s disease pathological behavior rating scale (BEHAVE-AD) to compare the pathological behavior of different stages after treatment. Statistical analysis showed that there was no significant difference between the total score of BEHAVE-AD and the scores of each factor in each week after treatment. The non-treatment adverse reaction scale (TESS) of the study group and the control group was analyzed by meta-analysis. The TESS score of the study group after treatment was significantly lower than that of the control group. The BPRS scores of different stages after treatment were analyzed by meta-analysis, and there was no significant difference in the total score and factor scores of BPRS in each week after treatment. Two clinical trials reported the incidence of neurological symptoms after treatment. Olanzapine and clozapine treatment can effectively reduce the risk of aging. There was no significant difference in the incidence of neurological symptoms in patients with dementia ( P > 0.05 ). According to the analysis of meat products, the incidence of adverse reactions in the study group was significantly lower than that in the control group ( P < 0.05 ). Conclusion. Olanzapine and clozapine have similar efficacy when treating mental and behavioral disorders in patients with senile dementia, in which olanzapine is more effective in improving the symptoms of patients with Alzheimer’s disease (AD), with less adverse reactions and high safety, which is worth popularizing in clinical practice. However, more studies and follow-up with higher methodological quality and longer intervention time are needed to further verify.

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“…30,31 Similarly, recommendations of risperidone in the ED setting may be characterized as favorable, considering risperidone's low anticholinergic side-effect profile and its proven efficacy in delirium and against dementia-related behavioral disturbances. 32,33 Haloperidol in age-adapted doses is also suitable in cases of acute agitation or psychosis in the ED, but should not be recommended for longterm use in geriatric patients in view of its numerous side effects. 33 Avoidance of DDIs is a target of rational drug therapy in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Drug Safety Profiles of Geriatric Patients Referred to Consultation Psychiatry in the Emergency Department—A Retrospective Cohort Study

Westhoff

Schröder

Heck

et al. 2023

J Geriatr Psychiatry Neurol

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Objective Geriatric patients account for a significant proportion of the collective treated by psychiatric consultation service in hospitals. In the Emergency Department (ED), psychotropic drugs are frequently recommended, notwithstanding their extensive side-effect profiles. This study sought to investigate medication safety of geriatric patients referred to psychiatric consultation service in the ED. Methods Medication lists of 60 patients from the general internal medicine and trauma surgery EDs referred to psychiatric consultation service were analyzed. Utilizing PRISCUS list and Fit fOR The Aged (FORTA) classification, prescriptions of potentially inappropriate medications (PIMs) were assessed. Results 84 drugs were newly prescribed following psychiatric consultations. The total number of drugs per patient was 5.4 ± 4.2 before psychiatric consultation and 6.5 ± 4.2 thereafter ( p < .001). 22.6 % of the newly recommended drugs were PIMs according to the PRISCUS list, while 54.8 % were designated as therapeutic alternatives to PIMs. 54.8 % and 20.2 % of the newly recommended drugs were FORTA category C and D drugs, respectively. An average of 1.2 ± 1.7 drug–drug interactions (DDIs) existed before psychiatric consultation and 1.3 ± 1.9 DDIs thereafter ( p = .08). Conclusion The majority of newly recommended drugs by psychiatric consultation service in the ED were designated as suitable therapeutic alternatives to PIMs according to the PRISCUS list, but had comparatively unfavorable ratings according to the FORTA classification, demonstrating discrepancies between these two PIM classification systems. Physicians delivering psychiatric consultation services in the ED should not solely rely on one PIM classification system.

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Antipsychotics for agitation and psychosis in people with Alzheimer's disease and vascular dementia

Abstract: Antipsychotics for agitation and psychosis in people with Alzheimer's disease and vascular dementia (Review)

Cited by 22 publications

References 41 publications

Efficacy of Donepezil Hydrochloride plus Olanzapine for Senile Dementia and Its Effect on the Recovery of Cognitive Function

Efficacy of Donepezil Hydrochloride plus Olanzapine for Senile Dementia and Its Effect on the Recovery of Cognitive Function

Meta-Analysis of the Efficacy and Safety of Olanzapine versus Clozapine when Treating Senile Dementia

Drug Safety Profiles of Geriatric Patients Referred to Consultation Psychiatry in the Emergency Department—A Retrospective Cohort Study

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