PMID- 16416461
OWN - NLM
STAT- MEDLINE
DCOM- 20060801
LR  - 20181203
IS  - 0885-6230 (Print)
IS  - 0885-6230 (Linking)
VI  - 21
IP  - 2
DP  - 2006 Feb
TI  - Can risperidone and olanzapine in elderly patients with dementia and other mental 
      disorders be discontinued?
PG  - 140-6
AB  - BACKGROUND: In March 2004, the UK Committee of Safety of Medicines (CSM) informed 
      clinicians that risperidone and olanzapine should not be used to treat 
      behavioural and psychological symptoms of dementia (BPSD) because of increased 
      risk of strokes with both drugs and increased risk of mortality with olanzapine. 
      An audit to examine the implications of the implementation of the CSM guidance 
      was undertaken. METHODS: All patients receiving these two drugs, in one 
      psychogeriatric service, at the time of CSM guidance were identified and 
      reviewed. Data on clinical and demographic features, patient and carer 
      involvement in the review and clinical outcome of the efficacy of the overall 
      treatment package at 6 month follow-up was ascertained from the case-notes. 
      RESULTS: The main findings were: (i) all patients receiving risperidone or 
      olanzapine were identified and reviewed at a median interval of 8 days after the 
      CSM guidance; (ii) most patients and carers were involved in the initial review; 
      (iii) risperidone and olanzapine were discontinued in 22 and 12 of the patients 
      respectively, and in 19 of these patients another neuroleptic was substituted; 
      (iv) there was no relationship between discontinuation of these two drugs and 
      presence of cerebrovascular and cardiovascular risk factors; and, (v) there was 
      no relationship between the clinical outcome of efficacy at six months and 
      discontinuation of these two drugs. CONCLUSIONS: This study illustrates that it 
      is possible to identify, review and follow-up patients on these two drugs and 
      involve the patient and carer in the review, and clinical outcome of efficacy of 
      the overall treatment package is not adversely affected by continuation or 
      discontinuation of these two drugs.
CI  - Copyright (c) 2006 John Wiley & Sons, Ltd.
FAU - Shah, Ajit
AU  - Shah A
AD  - West London Mental Health NHS Trust, London and Imperial College School of 
      Medicine, London, UK. a.k.shah@ic.ac.uk
LA  - eng
PT  - Journal Article
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
RN  - 0 (Antipsychotic Agents)
RN  - 12794-10-4 (Benzodiazepines)
RN  - L6UH7ZF8HC (Risperidone)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Aged, 80 and over
MH  - Antipsychotic Agents/*therapeutic use
MH  - Benzodiazepines/therapeutic use
MH  - Cardiovascular Diseases/chemically induced
MH  - Cerebrovascular Disorders/chemically induced
MH  - Dementia/*drug therapy
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Audit/methods
MH  - Olanzapine
MH  - Practice Guidelines as Topic
MH  - Risk Factors
MH  - Risperidone/*therapeutic use
MH  - Treatment Outcome
MH  - Withholding Treatment
EDAT- 2006/01/18 09:00
MHDA- 2006/08/02 09:00
CRDT- 2006/01/18 09:00
PHST- 2006/01/18 09:00 [pubmed]
PHST- 2006/08/02 09:00 [medline]
PHST- 2006/01/18 09:00 [entrez]
AID - 10.1002/gps.1438 [doi]
PST - ppublish
SO  - Int J Geriatr Psychiatry. 2006 Feb;21(2):140-6. doi: 10.1002/gps.1438.