Amisulpride versus Risperidone Treatment for Behavioral and Psychological Symptoms in Patients with Dementia of the Alzheimer Type: A Randomized, Open, Prospective Study

Abstract

The aim of this study was to evaluate the effectiveness and tolerability of both amisulpride and risperidone for treating the behavioral and psychological symptoms of dementia in patients with dementia of the Alzheimer type (DAT). Twenty-eight patients with DAT were randomly assigned to treatment with either amisulpride or risperidone for 8 weeks. The effectiveness of the treatments was assessed with the Neuropsychiatric Inventory (NPI) and the Clinical Global Impression-Severity of Illness (CGI-S) scale. The Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects. The NPI and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by treatment group interaction effect (F = 71.85, p < 0.0001). There were no serious adverse events in both groups. This study showed that either amisulpride or risperidone would be effective and tolerable for treating patients with DAT. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.

Successful Treatment With Amisulpride for Poststroke Psychosis

“…5 Although vascular dementia has been reported, with high percentages of delusions and hallucinations, our patient is relatively younger than the mean age in these studies. Amisulpride, a relatively pure dopamine (D 2 ) antagonist, 4 has been studied for treatment in Alz-heimer's disease with behavior and psychological symptoms of dementia in comparison to risperidone in randomized open trials.…”

Amisulpride in Refractory Behavioral and Psychological Symptoms of Dementia

“…Agitated Behavior Scale (ABS) [18], was used for categorization of BPSD as per ABS scores and patients were classified as mild (22)(23)(24)(25)(26)(27)(28), moderate (29)(30)(31)(32)(33)(34)(35)) and severe (>36). Agitated behavior scale (ABS) score > 22 meant absence of clinically significant agitation.…”

“…Only one other study to the best of our knowledge has explored the safety and tolerability of amisulpride in BPSD [28]. This small off label study (n=28) had taken patients with dementia of Alzheimer's type and compared amisulpride with risperidone.…”

Towards a therapeutic window of D2/3 occupancy for treatment of psychosis in Alzheimer's disease, with [18F]fallypride positron emission tomography

“…After the baseline scan, amisulpride was commenced at a dose of 25 or 50 mg daily (determined by the prescribing clinician). Follow-up assessments were conducted every 14 ± 7 days, with the aim of assessing symptoms and side effects through amisulpride dose titration (50-200 mg), on the basis of the dose range used in open-label trials (Lim et al, 2006;Mauri et al, 2006). Medication was administered in the evening by a carer in all but one participant, who lived alone and in whom compliance was facilitated through the use of a blister pack.…”