Carbamazepine Treatment of Agitation in Nursing Home Patients with Dementia: A Preliminary Study

Tariot, Pierre N.; Erb, Rosemary; Leibovici, Adrian; Podgorski, Carol; Cox, Christopher; Asnis, Jamie; Kolassa, John E.; Irvine, Carrie

doi:10.1111/j.1532-5415.1994.tb06982.x

Cited by 109 publications

(55 citation statements)

References 38 publications

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“…Recommendations about the use of carbamazepine to treat aggression in elderly demented patients have been tempered by concerns about its potential to cause serious haematological sideeffects (Leong and Silva, 1988). There were no such adverse effects in our sample and indeed none reported in the previous case series involving 66 patients (Chambers et al, 1982;Patterson, 1988;Gleason and Schneider, 1990;Tariot et al, 1994). However, longer follow-up studies would clarify its safety over more prolonged periods of treatment.…”

Section: ' 8 9 17contrasting

confidence: 44%

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Carbamazepine Use in Aggressive Behaviour Associated With Senile Dementia

Cooney

Mortimer²,

Smith

et al. 1996

Int. J. Geriat. Psychiatry

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Section: ' 8 9 17contrasting

confidence: 44%

“…Two previous placebo-controlled studies to assess the efficacy of carbamazepine in this context yielded conflicting results (Tariot et al, 1994;Chambers et al, 1982). Chambers et al (1982) reported a lack of efficacy of carbamazepine in their trial.…”

mentioning

confidence: 95%

Carbamazepine Use in Aggressive Behaviour Associated With Senile Dementia

Cooney

Mortimer²,

Smith

et al. 1996

Int. J. Geriat. Psychiatry

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“…Target symptoms in trials and in clinical practice have been primarily agitated or aggressive behavior, and not psychosis. Three controlled studies examined the effect of carbamazepine on symptoms of tension, hostility, uncooperativeness, or excitement in patients with advanced AD [81] or with AD or vascular dementia [82,83]. One study included outpatients who had previously not responded to neuroleptic treatment [81].…”

Section: Anticonvulsantsmentioning

confidence: 99%

Psychosis and Antipsychotic Medications in Alzheimer’s Disease: Clinical Management and Research Perspectives

Sultzer

2003

Dement Geriatr Cogn Disord

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Psychosis is common in patients with Alzheimer’s disease (AD) and contributes substantially to patient morbidity and caregiver distress. Antipsychotic medications are used to treat psychosis and other psychiatric or behavioral symptoms in AD, although optimal treatment guidelines have been elusive. Choosing the most advantageous medication for an individual patient is challenging. This article provides an overview of clinical management principles and medication treatment strategies for patients with AD and psychosis. Effects of individual medications are also described. Medications in the conventional neuroleptic, atypical antipsychotic, cholinesterase inhibitor, and serotonergic classes have been shown to ameliorate psychosis and behavioral symptoms in patients with AD, although the evidence is not conclusive for many medications. Side effects vary substantially across medication classes and modestly among individual patients. Improvement in agitation, aggression, or other behaviors with antipsychotic medication treatment may not depend on distinct antipsychotic effects. In contrast, there is preliminary evidence that delusions and hallucinations may respond to treatment with medications outside the antipsychotic class. Many important clinical questions warrant further research study. In particular, studies to compare how individual symptoms respond to different medications, and to examine how to best manage overlapping symptoms or incomplete treatment response are needed.

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“…95 Carbamazepine was studied in the treatment of agitation and psychosis and reported benefits. 96 The antidepressant agent citalopram was proposed as a treatment for agitation in a poorly defined population with "cognitive deficits." 97 Depression.…”

Section: Ischemic Vascular Dementiamentioning

confidence: 99%

Practice parameter: Management of dementia (an evidence-based review) [RETIRED]

et al. 2001

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Article abstract-Objective: To define and investigate key issues in the management of dementia and to make literaturebased treatment recommendations. Methods: The authors searched the literature for four clinical questions: 1) Does pharmacotherapy for cognitive symptoms improve outcomes in patients with dementia? 2) Does pharmacotherapy for noncognitive symptoms improve outcomes in patients with dementia? 3) Do educational interventions improve outcomes in patients and/or caregivers? 4) Do other nonpharmacologic interventions improve outcomes in patients and/or caregivers? Results: Cholinesterase inhibitors benefit patients with AD (Standard), although the average benefit appears small; vitamin E likely delays the time to clinical worsening (Guideline); selegiline, other antioxidants, antiinflammatories, and estrogen require further study. Antipsychotics are effective for agitation or psychosis in patients with dementia where environmental manipulation fails (Standard), and antidepressants are effective in depressed patients with dementia (Guideline). Educational programs should be offered to family caregivers to improve caregiver satisfaction and to delay the time to nursing home placement (Guideline). Staff of long-term care facilities should also be educated about AD to minimize the unnecessary use of antipsychotic medications (Guideline). Behavior modification, scheduled toileting, and prompted voiding reduce urinary incontinence (Standard). Functional independence can be increased by graded assistance, skills practice, and positive reinforcement (Guideline).

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Carbamazepine Treatment of Agitation in Nursing Home Patients with Dementia: A Preliminary Study

Abstract: This preliminary study suggests that carbamazepine in low doses can reduce agitated behaviors in some patients, with limited adversity resulting. Further research is required to confirm and extend this finding before it can be considered routine clinical practice.

Cited by 109 publications

References 38 publications

Carbamazepine Use in Aggressive Behaviour Associated With Senile Dementia

Carbamazepine Use in Aggressive Behaviour Associated With Senile Dementia

Psychosis and Antipsychotic Medications in Alzheimer’s Disease: Clinical Management and Research Perspectives

Practice parameter: Management of dementia (an evidence-based review) [RETIRED]

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