PMID- 15207416
OWN - NLM
STAT- MEDLINE
DCOM- 20041021
LR  - 20181130
IS  - 0924-7947 (Print)
IS  - 0924-7947 (Linking)
IP  - 9
DP  - 2004
TI  - Comparison of the efficacy of new and conventional antipsychotic drugs in the 
      treatment of behavioral and psychological symptoms of dementia (BPSD).
PG  - 207-15
AB  - This double-blind study evaluated the efficacy and safety of risperidone or 
      olanzapine vs. promazine in the treatment of behavioral and psychological 
      symptoms in dementia(BPSD). Patients were required to be 65 years or older, to 
      have DSM-IV diagnoses of Alzheimer's disease (AD), vascular dementia (VD) or a 
      combination of both. A brain computerized tomography (CT) was performed for all 
      the patients; 60 demented patients,27 men (45 %) and 33 women (55 %) were 
      selected for this study. The University of California Los Angeles 
      neuropsychiatric inventory (NPI) was administered at baseline, then after 4 and 8 
      weeks. Patients had at least a score of 24 or more. The Hoehn and Yahr scale was 
      used for evaluating parkinsonism. The scales were administered by an examinator 
      who was not aware of the kind of treatment of the patients. After a wash-out 
      period of 10 days,20 patients, 9 men and 11 women, mean age 76.6 +/- 6.0 years, 
      were randomly assigned torisperidone 1 mg daily in divided doses (morning and 
      bedtime) (Group A); 20 patients, 9 men and 11 women, mean age 82.5 +/- 9.3 years 
      were randomly assigned to olanzapine 5mg at bedtime (Group B), and 20 patients, 9 
      men and 11 women, mean age 77.6 +/- 4.6 years, were randomly assigned to 
      promazine 50 mg daily (morning and bedtime) (Group C). In case of lack of 
      clinical response, after 4 weeks, the dose could be increased to 2 mg/day of 
      risperidone, 10 mg/day of olanzapine, and to 100 mg/day of promazine in the 
      respective groups. Repeated measures ANOVA was used for the statistical analysis 
      of rating scales over time (baseline, 4 and 8 weeks). At the end of the 8th week, 
      a global improvement was obtained in 80% of patients treated with risperidone and 
      olanzapine, vs. 65 % of patients treated with promazine (p < 0.01). The results 
      show that risperidone in doses of 1-2 mg/day and olanzapine in doses of 5-10 
      mg/day are effective and safe in the treatment of BPSD. Risperidone presents a 
      major and dose-dependent antidopaminergic action and seems to be preferable when 
      hallucinations and delusions are prevailing symptoms, even if it gives good 
      results on aggression and wandering. Olanzapine seems to be faster in its 
      sedative effect, probably for H1 receptor blockade. Moreover, 5-HT6 antagonism 
      may favor acetylcholine release and this explains why these patients have not 
      presented a cognitive worsening. However, both drugs are comparable or even 
      superior to promazine, with significantly fewer side effects of both 
      anticholinergic and extrapyramidal character.
FAU - Gareri, P
AU  - Gareri P
AD  - Department of Experimental and Clinical Medicine, Mater Domini University 
      Hospital of Catanzaro, I-88100 Cantanzaro, Italy.
FAU - Cotroneo, A
AU  - Cotroneo A
FAU - Lacava, R
AU  - Lacava R
FAU - Seminara, G
AU  - Seminara G
FAU - Marigliano, N
AU  - Marigliano N
FAU - Loiacono, A
AU  - Loiacono A
FAU - De Sarro, G
AU  - De Sarro G
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Ireland
TA  - Arch Gerontol Geriatr Suppl
JT  - Archives of gerontology and geriatrics. Supplement
JID - 8911786
RN  - 0 (Antipsychotic Agents)
RN  - 12794-10-4 (Benzodiazepines)
RN  - L6UH7ZF8HC (Risperidone)
RN  - N7U69T4SZR (Olanzapine)
RN  - O9M39HTM5W (Promazine)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Alzheimer Disease/*psychology
MH  - Antipsychotic Agents/adverse effects/*therapeutic use
MH  - Benzodiazepines/adverse effects/*therapeutic use
MH  - Brain/diagnostic imaging
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Mental Disorders/*drug therapy/*etiology
MH  - Olanzapine
MH  - Promazine/adverse effects/*therapeutic use
MH  - Psychomotor Disorders/*drug therapy/*etiology
MH  - Risperidone/adverse effects/*therapeutic use
MH  - Tomography, X-Ray Computed
EDAT- 2004/06/23 05:00
MHDA- 2004/10/22 09:00
CRDT- 2004/06/23 05:00
PHST- 2004/06/23 05:00 [pubmed]
PHST- 2004/10/22 09:00 [medline]
PHST- 2004/06/23 05:00 [entrez]
AID - S0167494304000640 [pii]
AID - 10.1016/j.archger.2004.04.029 [doi]
PST - ppublish
SO  - Arch Gerontol Geriatr Suppl. 2004;(9):207-15. doi: 10.1016/j.archger.2004.04.029.