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

Oshima, Norihito

doi:10.1111/j.1479-8301.2008.00243.x

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…Even though the pathogenesis of BPSD is not yet fully understood, 1 clinicians are often expected to reduce the frequency and severity of BPSD by whatever means available; however, this is sometimes quite difficult. [2][3][4][5] Therefore, BPSD may increase the burden on patients' family and caregivers, and may be the main reason for visits to the hospital and/or clinic by patients and their families. 6 Alzheimer's disease not only affects the quality of life (QOL) of patients, but is also considered a considerable burden by caregivers.…”

Section: Introductionmentioning

confidence: 99%

Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimer's disease

et al. 2009

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Background: To evaluate the impact of donepezil hydrochloride on the care burden on family members of patients with Alzheimer's disease (AD). At present, donepezil is the only drug approved for the treatment of AD in Japan. Although the care burden on primary caregivers of AD patients comprises both physical and psychological burdens and donepezil is recognized to improve cognitive dysfunction and associated symptoms, there are few data on the effects of the drug on the care burden. Methods: Of the uninstitutionalized AD patients who visited a dementia clinic between June 2008 and May 2009 with their primary family caregivers, 416 subjects who satisfied the enrollment criteria were registered for the study. All participants provided informed consent. Assessment included changes in scores on the Japanese version of the Zarit Caregiver Burden Interview ( J-ZBI) and the Mini-Mental State Examination (MMSE), as well as the presence of behavioral and psychological symptoms of dementia (BPSD). Caregivers answered the questionnaires at baseline and after 12 weeks treatment with donepezil (starting dose 3 mg, p.o., once daily, followed by 5 mg after 1 or 2 weeks). Results: There were significant changes in mean scores on the J-ZBI (-1.9 1 9.5; P < 0.01) and MMSE (+0.9 1 2.9; P < 0.01) from baseline to Week 12, without significant correlation between these two scores. In patients with BPSD, there was a significant decrease in J-ZBI scores over the 12 weeks (P = 0.013); in contrast, in patients without BPSD, the decrease in the J-ZBI score did not reach statistical significance (P = 0.418). Conclusions:The results indicate that donepezil improves cognitive function and some of the BPSD. As a possible consequence of improvements in BPSD, donepezil may also reduce caregivers' burden.

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Section: Introductionmentioning

confidence: 99%

Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimer's disease

et al. 2009

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“…At present, clinicians are expected to attend 2 million dementia patients with behavioral and psychological problems of dementia, which causes a serious burden to the patients as well as to the caregivers 2 . Pharmacological treatment, mainly by anti‐psychotics, works with some patients, 3–5 but is not always useful. Some opinions recommend refraining from prescribing anti‐psychotics for dementia with behavioral and psychological problems of dementia, 6 and Chinese herbal medicine is recommended by some opinion leaders 7–9 .…”

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confidence: 99%

Apolipoprotein E and central nervous system disorders: Reviews of clinical findings

Takeda

Martínez

Kudo

et al. 2010

Psychiatry Clin Neurosci

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Dementia is a major health problem in developed countries with over 25 million people affected worldwide and probably over 75 million people at risk during the next 20 years. Alzheimer's disease (AD) is the most frequent cause of dementia (50-70%), followed by vascular dementia (30-40%), and mixed dementia (15-20%). AD pathogenesis is still to be elucidated but it is believed to be the complex interaction between genetic and environmental factors in later life. Three causative genes for familial AD have been identified: amyloid precursor protein, presenilin-1, and presenilin-2. There are 150 genes involved with increased neuronal vulnerability to premature death in the AD brain. Among these susceptibility genes, the apolipoprotein E (ApoE) gene is the most prevalent as a risk for AD pathogenic process in which complex interactions between genetic and environmental factors are involved, leading to a cascade of pathogenic events converging in final pathways to premature neuronal death. Some of these mechanisms are common to several neurodegenerative disorders that differ depending upon the genes affected and the involvement of environmental conditions.ApoE is a key lipoprotein in lipid and cholesterol metabolism and it is also the major risk gene for AD and many other central nervous system disorders. The pathogenic role of ApoE-4 is still to be clarified; however, diverse evidence suggests that ApoE may play pleiotropic functions in dementia and central nervous system disorders.

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“…In April 2004, the US Food and Drug Administration (FDA) issued a warning stating that the use of atypical antipsychotics in the elderly increased their mortality rate. In accordance with this warning, it was widely announced in Japan that antipsychotics were not indicated as a treatment for dementia 36 . We must recognize that the use of psychotropic drugs is ‘off‐label use’, meaning the prescription of a drug without approved official authorization.…”

Section: Discussionmentioning

confidence: 99%

Management of behavioral and psychological symptoms of dementia in long‐term care facilities in Japan

et al. 2009

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Background: An increasing number of old people, and their medical requirements, cannot be managed by their families in their homes, which has been the traditional and prevalent practice in Japan. The number of people with dementia is increasing and behavioral and psychological symptoms of dementia (BPSD) make care difficult. In the present study, we investigated management techniques for BPSD in long-term care facilities in Japan by using the data mining method, which looks at the reported behaviors of care providers. Methods: First, interviews were conducted with 15 care providers to develop items for a questionnaire. These data were analyzed qualitatively and synthesized with criteria from the professional literature. The resulting self-report questionnaire on techniques used to manage different symptoms of dementia was completed by 275 care providers. We applied the association rule as a data mining method examining 15 management techniques related to 13 BPSD. Results: Analysis identified four types of management techniques: (i) emotional and behavior-concordance techniques; (ii) acceptance and supportive techniques; (iii) restraining techniques; and (iv) avoidance techniques. Different management techniques, and combinations of techniques, were found to vary in use and effectiveness with different BPSD. Conclusions: Good management techniques for many BPSD have been developed and are being implemented by care providers. The present study has the potential to inform researchers and care providers in Japan about the types of management techniques in current use, as well as areas of potential need for staff training.

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

Cited by 7 publications

References 13 publications

Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimer's disease

Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimer's disease

Apolipoprotein E and central nervous system disorders: Reviews of clinical findings

Management of behavioral and psychological symptoms of dementia in long‐term care facilities in Japan

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