Behavioral and psychological symptoms of dementia (BPSD) in elderly demented subjects: Is the long lasting use of atypical antipsychotic drugs useful and safe?

Angelini, A; Bendini, Chiara; Neviani, Francesca; Neri, Mirco

doi:10.1016/j.archger.2007.01.005

Cited by 14 publications

(8 citation statements)

References 37 publications

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“…In terms of adverse events, the incidence of EPS has been reported to be 15.6% following BPSD treatment with atypical antipychotics 8 . This is consistent with the incidence of EPS observed in patients in the present study.…”

Section: Discussionsupporting

confidence: 92%

Beneficial and adverse effects of pharmacotherapy with risperidone on behavioral and psychological symptoms of dementia (BPSD)

Oshima¹

2008

Psychogeriatrics

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Background: Behavioral and psychological symptoms of dementia (BPSD) increase the burden of caregiving. In 2004, the US Food and Drug Administration issued a warning on an increase in the mortality rate in elderly patients using antipsychotics. Thereafter, although the need for antipsychotics for BPSD has increased, discussions regarding their indication have continued.Methods: The present study was performed in 18 patients with Alzheimer's disease (AD) and patients with vascular dementia (VaD) who were treated with risperidone because of BPSD. Changes in the dose of risperidone and the beneficial and adverse effects of risperidone were evaluated for 3 months after the start of antipsychotic therapy. Results: The mean starting dose of risperidone was 0.62 1 0.30 mg (62 1 30 mg chlorpromazine (CP) equivalents), which, after 3 months, increased to 0.99 1 0.49 mg risperidone (99 1 49 mg CP equivalents). The symptoms of BPSD at the beginning of treatment were delusions (48% of patients) and violence (22% of patients). In the 3-month treatment period, an improvement in BSPD symptoms was recorded in 78% of patients. During the study period, adverse effects were observed in 65% of patients: 26% of patients reported falling and extrapyramidal symptoms were seen in 13%. There were no cardiovascular events or deaths. Conclusion: In the present study, low doses of risperidone were used for the treatment of BPSD and no serious side-effects were observed. An atypical antipsychotic can be one of the treatment options if a thorough risk assessment of the cardiovascular system is made and informed consent is obtained.

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Section: Discussionsupporting

confidence: 92%

Beneficial and adverse effects of pharmacotherapy with risperidone on behavioral and psychological symptoms of dementia (BPSD)

Oshima¹

2008

Psychogeriatrics

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“…We used established cut‐off item score of ≥4 as a point of determination of clinical significance, which includes a moderately severe symptoms at frequency rating of “often” or more frequently and “mild symptoms” present “very frequent,” as previously reported . Neuropsychiatric Inventory total score is summed to a maximum possible of 144, and we used NPI total score >36 as cut‐off as suggested by others …”

Section: Methodsmentioning

confidence: 99%

“…28 A quarter of the patients at any time had NPI total score >36, which is above the score considered in need of antipsychotic drug treatment in trials. 20,21 Previous longitudinal studies have reported that NPS increase over time, 5,29 and are associated with duration of disease 22 and time. 30 Our finding that NPS are associated with cognitive decline is also consistent with other studies.…”

Section: High Nps Scores Are Common Also In Early Dementiamentioning

confidence: 99%

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Course of neuropsychiatric symptoms in dementia: 5‐year longitudinal study

Vik‐Mo

Giil

Ballard

et al. 2018

Int J Geriat Psychiatry

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“…Risperidone which is considered first line management in agitated dementia with delusions [47] was the antipsychotic of choice in this study with patients experiencing a neurocognitive disorder. Although atypical antipsychotics were found to be safe and efficacious in elderly mental health clients [48], antipsychotics as a class of medication have been associated with the greatest level of fall risk in both dementia specific and mental health inpatient and community settings [42]. Long term use increases falls risk however initiation has been associated with higher fracture rates [40].…”

Section: Medicationmentioning

confidence: 99%

Preventing falls in In-Patient Older Adult Mental Health Services: Different Causative Factors in Mental and Neurocognitive Disorders

Heslop¹,

Wynaden²,

Tohotoa³

2014

J Gerontol Geriatr Res

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Aims: To compare falls sustained in two groups of patients (one with mental disorders and the other neurocognitive disorders), in two acute inpatient older adult mental health services in Western Australia (WA).Background: Falls are the most common adverse event experienced during inpatient care. Older people with mental disorders and neurocognitive disorders constitute a high-risk group for accidental falls in hospitals.

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Behavioral and psychological symptoms of dementia (BPSD) in elderly demented subjects: Is the long lasting use of atypical antipsychotic drugs useful and safe?

Cited by 14 publications

References 37 publications

Beneficial and adverse effects of pharmacotherapy with risperidone on behavioral and psychological symptoms of dementia (BPSD)

Beneficial and adverse effects of pharmacotherapy with risperidone on behavioral and psychological symptoms of dementia (BPSD)

Course of neuropsychiatric symptoms in dementia: 5‐year longitudinal study

Preventing falls in In-Patient Older Adult Mental Health Services: Different Causative Factors in Mental and Neurocognitive Disorders

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