PMID- 30666436
OWN - NLM
STAT- MEDLINE
DCOM- 20200225
LR  - 20200225
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 266
IP  - 10
DP  - 2019 Oct
TI  - Comparative efficacy and safety of therapy for the behavioral and psychological 
      symptoms of dementia: a systemic review and Bayesian network meta-analysis.
PG  - 2363-2375
LID - 10.1007/s00415-019-09200-8 [doi]
AB  - OBJECTIVE: To assess the comparative efficacy and safety of both pharmacological 
      and non-pharmacological therapies for the behavioral and psychological symptoms 
      of dementia, using direct and indirect evidence from randomized data. METHOD: A 
      systematic review and Bayesian network meta-analysis was conducted on only 
      randomized controlled trials (RCTs) of all the available interventions for BPSD. 
      RCTs were selected from Pubmed, EMBASE, the Cochrane library, and CINAHL. The 
      efficacy outcomes were Neuropsychiatric Inventory (NPI) and Cohen-Mansfield 
      Agitation Inventory (CMAI). The outcomes of safety were total adverse events 
      (AEs), diarrhea, dizziness, headache, falls, nausea, vomiting, and 
      cerebrovascular diseases. RESULT: 146 RCTs comprising 44,873 patients with BPSD 
      were included in this study. On NPI, aripiprazole (MD - 3.65, 95% credible 
      interval (CrI) = - 6.92 to - 0.42), escitalopram (MD - 6.79, 95% CrI - 12.91 to 
      - 0.60), donepezil (MD - 1.45, 95% CrI - 2.70 to - 0.20), galantamine (MD - 1.80, 
      95% CrI - 3.29 to - 0.32), memantine (MD - 2.14, 95% CrI - 3.46 to - 0.78), and 
      risperidone (MD - 3.20, 95% CrI - 6.08 to - 0.31) were superior to placebo. On 
      CMAI, aripiprazole (MD - 4.00, 95% CrI - 7.39 to - 0.54) and risperidone (MD 
      - 2.58, 95% CrI - 5.20 to - 0.6) showed superiority to placebo. On the risk of 
      total AEs, donepezil (OR 1.27, 95% CrI 1.07-1.50), galantamine (OR 1.91, 95% CrI 
      1.58-2.36), risperidone (OR 1.47, 95% CrI 1.13-1.97), and rivastigmine (OR 2.02, 
      95% CrI 1.53-2.70) owned higher risk than placebo. CONCLUSION: Pharmacological 
      therapies should be the first choice for BPSD. Aripiprazole, haloperidol, 
      quetiapine, and risperidone of antipsychotics showed the significant efficacy, 
      while memantine, galantine, and donepezil may provide the modest effectiveness. 
      The safety of all was thought to be acceptable.
FAU - Jin, Boru
AU  - Jin B
AD  - Department of Neurology, First Affiliated Hospital, China Medical University, No. 
      155, North Nanjing Street, Shenyang, 110001, People's Republic of China.
FAU - Liu, Huayan
AU  - Liu H
AUID- ORCID: 0000-0001-9806-9003
AD  - Department of Neurology, First Affiliated Hospital, China Medical University, No. 
      155, North Nanjing Street, Shenyang, 110001, People's Republic of China. 
      liuhuayancmu@163.com.
LA  - eng
GR  - 20170541036/Natural Science Foundation of Liaoning Province/
PT  - Comparative Study
PT  - Journal Article
PT  - Systematic Review
DEP - 20190121
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Nootropic Agents)
SB  - IM
MH  - Antipsychotic Agents/adverse effects/*pharmacology
MH  - Dementia/*drug therapy/physiopathology/psychology
MH  - Humans
MH  - *Network Meta-Analysis
MH  - Nootropic Agents/adverse effects/*pharmacology
OTO - NOTNLM
OT  - Behavioral and psychological symptoms of dementia
OT  - Dementia
OT  - Network meta-analysis
OT  - Non-pharmacological therapy
OT  - Pharmacological therapy
OT  - Systematic review
EDAT- 2019/01/23 06:00
MHDA- 2020/02/26 06:00
CRDT- 2019/01/23 06:00
PHST- 2018/11/04 00:00 [received]
PHST- 2019/01/12 00:00 [accepted]
PHST- 2019/01/10 00:00 [revised]
PHST- 2019/01/23 06:00 [pubmed]
PHST- 2020/02/26 06:00 [medline]
PHST- 2019/01/23 06:00 [entrez]
AID - 10.1007/s00415-019-09200-8 [pii]
AID - 10.1007/s00415-019-09200-8 [doi]
PST - ppublish
SO  - J Neurol. 2019 Oct;266(10):2363-2375. doi: 10.1007/s00415-019-09200-8. Epub 2019 
      Jan 21.