Use of Low-Dose Gabapentin for Aggressive Behavior in Vascular and Mixed Vascular/Alzheimer Dementia

Cooney, Colm; Murphy, Sinead; Tessema, Hiberet; Freyne, Aideen

doi:10.1176/appi.neuropsych.12050115

Cited by 29 publications

(16 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 24 publications that met our criteria for inclusion , 15 contained original data (case reports or case series) , whereas nine were solely reviews of the literature with no original data . One of the 15 papers that contained an original report additionally included a narrative review.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Gabapentin and pregabalin to treat aggressivity in dementia: a systematic review and illustrative case report

Supasitthumrong

Bolea-Alamañac

Asmer

et al. 2019

Brit J Clinical Pharma

View full text Add to dashboard Cite

AIMSThe prevalence of dementia is rising as life expectancy increases globally. Behavioural and psychological symptoms of dementia (BPSD), including agitation and aggression, are common, presenting a challenge to clinicians and caregivers. METHODSFollowing PRISMA guidelines, we systematically reviewed evidence for gabapentin and pregabalin against BPSD symptoms of agitation or aggression in any dementia, using six databases (Pubmed, CINHL, PsychINFO, HealthStar, Embase, and Web of Science). Complementing this formal systematic review, an illustrative case of a patient with BPSD in mixed Alzheimer's/vascular dementia, who appeared to derive benefits in terms of symptom control and functioning from the introduction of gabapentin titrated up to 3600 mg day À1 alongside other interventions, is presented. RESULTSTwenty-four relevant articles were identified in the systematic review. There were no randomized trials. Fifteen papers were original case series/case reports of patients treated with these compounds, encompassing 87 patients given gabapentin and six given pregabalin. In 12 of 15 papers, drug treatment was effective in the majority of cases. The remaining nine papers were solely reviews, of which two were described as systematic but predated PRISMA guidelines. Preliminary low-grade evidence based on case series and case reviews suggests possible benefit of gabapentin and pregabalin in patients with BPSD in Alzheimer's disease. These benefits cannot be confirmed until well-powered randomized controlled trials are undertaken. Evidence in frontotemporal dementia is lacking. CONCLUSIONGabapentin and pregabalin could be considered for BPSD when medications having stronger evidence bases (risperidone, other antipsychotics, carbamazepine and citalopram) have been ineffective or present unacceptable risks of adverse outcomes.British Journal of Clinical Pharmacology Br J Clin Pharmacol (2019) 85 690-703 690 Gabapentin and pregabalin in dementia treatment Br J Clin Pharmacol (2019) 85 690-703 691 Nomenclature of targets and ligandsKey protein targets and ligands in this article are hyperlinked to corresponding entries in the http://www. guidetopharmacology.org, the common portal for data from the IUPHAR/BPS Guide to PHARMACOLOGY [90], and are permanently archived in the Concise Guide to PHARMA-COLOGY 2017/18 [91].

show abstract

Section: Resultsmentioning

confidence: 99%

“…There was improvement measured by nursing report. No adverse effects were reported . In the most recent series identified, Bardet described six patients prescribed pregabalin (dose range 75–600 mg day −1 ).…”

Section: Resultsmentioning

confidence: 99%

Gabapentin and pregabalin to treat aggressivity in dementia: a systematic review and illustrative case report

Supasitthumrong

Bolea-Alamañac

Asmer

et al. 2019

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…Importantly, the immunohistochemistry data, showed that the intensity of BCATc labelling in both cell bodies and dendrites was most pronounced in the hippocampus, a region that is known to be particularly susceptible to excitotoxic neuronal injury at an early stage of AD, highlighting that sustained increase in BCATc may contribute to injury. In addition, the antiepileptic drug gabapentin, which inhibits BCATc, has proved successful in treating behavioural alterations in subjects with AD (Cooney et al 2013;Supasitthumrong et al 2019). A more widespread increase in the level of BCATm was also reported that extended throughout the frontal and temporal regions of AD brain.…”

Section: Glutamate Excitotoxicitymentioning

confidence: 99%

Alzheimer’s disease: targeting the glutamatergic system

Conway

2020

Biogerontology

117

View full text Add to dashboard Cite

BCATc Cytosolic BCAT BCATm Mitochondrial BCAT BCKA Branched chain a-keto acids BCKD Branched chain a-keto acid dehydrogenase Cho Choline Cr Creatinine Glu Glutamate Glx Glu?glutamine GDH Glutamate dehydrogenase MSUD Maple syrup urine disease NAA N-acetyl aspartate NMDAR N-methyl-D-aspartate receptor NFTs Neurofibrillary tangles PLP Pyridoxal phosphate PSEN1 Presenilin 1 1 H MRS Proton magnetic resonance spectroscopy mI Myoinositol TBI Traumatic brain injury

show abstract

“…In a retrospective design of cases Cooney et al [80] found that low-dose gabapentin could be effective in treatment of aggression in patients with vascular dementia. A recent systematic review by Supasitthumrong et al [81] about evidence of gabapentin and pregabalin in the management of NPS found low-evidence for the use of these medications for that matter.…”

Section: Gabapentin Lamotrigine and Oxcarbazepinementioning

confidence: 99%

Management of Neuropsychiatric Symptoms of Dementia: A Comprehensive Review of the Current Literature

Suarez¹,

Shafi²,

Lapid³

2019

obm geriatr

View full text Add to dashboard Cite

Background: Dementia is a progressive and debilitating condition that affects millions of patients in the United States with an enormous impact on healthcare costs, caregivers, and society. Patients with dementia often experience dementia-related neuropsychiatric disturbances, commonly known as Behavioral and Psychological Symptoms of Dementia (BPSD) and more recently Neuropsychiatric symptoms (NPS) in dementia. These symptoms include verbal and physical agitation, aggression, disinhibition, affect lability, apathy, psychosis, depression, and anxiety. Symptom management is important to optimize quality of life, minimize further functional decline, and delay institutionalization. We aim to review the existing published literature on pharmacologic and non-pharmacologic management of NPS. Methods: PubMed, Google Scholar, and Cochrane were searched for available reviews, systematic reviews, meta-analysis, and randomized controlled trials on diagnostic tools and treatment strategies for NPS. Some of the searched terms used included, "neuropsychiatric symptoms of dementia treatment," "NPS treatment," "pharmacologic treatment NPS," "non-pharmacologic treatment NPS," "scales NPS." We also searched for the term "BPSD" instead of "NPS" and "neurocognitive disorder" instead of "dementia." Recent Findings: There are different treatment modalities to address NPS, including pharmacologic and non-pharmacologic approaches, but the evidence throughout the years has been controversial and mostly studied in Alzheimer's disease population making less generalizable to other dementia populations. Summary: NPS continues to be a prevalent and debilitating condition in the elderly population with dementia. Non-pharmacologic strategies continue to be the first-line treatment for NPS despite lack of strong evidence because of their potential benefit and absence of side effects. Conversely, pharmacologic strategies have a potential risk for side effects in addition to the lack of strong evidence about their benefits in NPS; therefore, deprescribing is an important consideration in the management of these patients.

show abstract

Use of Low-Dose Gabapentin for Aggressive Behavior in Vascular and Mixed Vascular/Alzheimer Dementia

Cited by 29 publications

References 22 publications

Gabapentin and pregabalin to treat aggressivity in dementia: a systematic review and illustrative case report

Gabapentin and pregabalin to treat aggressivity in dementia: a systematic review and illustrative case report

Alzheimer’s disease: targeting the glutamatergic system

Management of Neuropsychiatric Symptoms of Dementia: A Comprehensive Review of the Current Literature

Contact Info

Product

Resources

About