WANG Xiaoli, TANG Muni, ZHANG Ruoxi. Effect of atypical antipsychotics on behavioral and psychological symptoms of dementia[J]. Journal of Clinical Medicine in Practice, 2023, 27(3): 121-126, 133. DOI: 10.7619/jcmp.20222070
Citation: WANG Xiaoli, TANG Muni, ZHANG Ruoxi. Effect of atypical antipsychotics on behavioral and psychological symptoms of dementia[J]. Journal of Clinical Medicine in Practice, 2023, 27(3): 121-126, 133. DOI: 10.7619/jcmp.20222070

Effect of atypical antipsychotics on behavioral and psychological symptoms of dementia

More Information
  • Received Date: July 04, 2022
  • Available Online: March 01, 2023
  • Objective 

    To investigate the efficacy and safety of atypical antipsychotics in treating behavioral and psychological symptoms of dementia (BPSD).

    Methods 

    A total of 118 dementia patients with BPSD were randomly divided into control group (n = 32), risperidone group (n = 22), quetiapine group (n = 29) and olanzapine group (n = 32). After 16 weeks of follow-up, negative polarity item (NPI) was used to evaluate the drug efficacy; Mini-Mental State Examination (MMSE) was used to assess the cognitive function of patients; Activities of Daily Living (ADL) was used to assess patients' daily living ability; Treatment Emergent Symptom Scale (TESS) was used to evaluate drug-related adverse reactions.

    Results 

    The NPI scores at each visit site in the olanzapine group and quetiapine group were significantly lower than those in the baseline period (P < 0.001); the NPI score at the end of eighth week in the risperidone group was significantly lower than that baseline period (P < 0.05). The scores of ADL, Instrumental Ability of Daily Living Scale (IADL) and Physical Life Self-care Scale (PSMS) in the control group at the 16th week were significantly higher than those in baseline period (P < 0.05). The incidence of dry mouth in the risperidone group was significantly higher than that in the quetiapine and olanzapine groups (P < 0.05).

    Conclusion 

    The BPSD of dementia patients in the risperidone group, quetiapine group, olanzapine group and control group is improved. The efficacy of the three drug groups is better than that of the control group, and the efficacy of the olanzapine group and quetiapine group is better than that of the risperidone group. There is no significant difference in safety among the three drug groups. In addition, treatment with atypical antipsychotics may help relieve BPSD's damage to the daily life ability of dementia patients.

  • [1]
    MAGIERSKI R, SOBOW T, SCHWERTNER E, et al. Pharmacotherapy of behavioral and psychological symptoms of dementia: state of the art and future progress[J]. Front Pharmacol, 2020, 11: 1168. doi: 10.3389/fphar.2020.01168
    [2]
    ANAND A, KHURANA P, CHAWLA J, et al. Emerging treatments for the behavioral and psychological symptoms of dementia[J]. CNS Spectr, 2018, 23(6): 361-369. doi: 10.1017/S1092852917000530
    [3]
    TIBLE O P, RIESE F, SAVASKAN E, et al. Best practice in the management of behavioural and psychological symptoms of dementia[J]. Ther Adv Neurol Disord, 2017, 10(8): 297-309. doi: 10.1177/1756285617712979
    [4]
    CANEVELLI M, REMOLI G, et al. Ongoing research protocols for the pharmacological treatment of neuropsychiatric symptoms in dementia[J]. J Frailty Aging, 2021, 10(1): 22-30.
    [5]
    CUMMINGS J, RITTER A, ROTHENBERG K. Advances in management of neuropsychiatric syndromes in neurodegenerative diseases[J]. Curr Psychiatry Rep, 2019, 21(8): 79. doi: 10.1007/s11920-019-1058-4
    [6]
    FORESTER B P, VAHIA I. Behavioral and psychological symptoms—an emerging crisis of the alzheimer dementia epidemic[J]. JAMA Netw Open, 2019, 2(3): e190790. doi: 10.1001/jamanetworkopen.2019.0790
    [7]
    CALSOLARO V, ANTOGNOLI R, OKOYE C, et al. The use of antipsychotic drugs for treating behavioral symptoms in alzheimer's disease[J]. Front Pharmacol, 2019, 10: 1465. doi: 10.3389/fphar.2019.01465
    [8]
    TAMPI R R, TAMPI D J, BALACHANDRAN S, et al. Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses[J]. Ther Adv Chronic Dis, 2016, 7(5): 229-245. doi: 10.1177/2040622316658463
    [9]
    YUNUSA I, ALSUMALI A, GARBA A E, et al. Assessment of reported comparative effectiveness and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia: a network meta-analysis[J]. JAMA Netw Open, 2019, 2(3): e190828. doi: 10.1001/jamanetworkopen.2019.0828
    [10]
    汪林兵, 喻跃国, 穆晞园, 等. 多奈哌齐与奥氮平联合治疗伴精神行为症状血管性痴呆的远期疗效[J]. 中国神经免疫学和神经病学杂志, 2019, 26(5): 366-367, 375. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSMB201905015.htm
    [11]
    CALSOLARO V, FEMMINELLA G D, ROGANI S, et al. Behavioral and psychological symptoms in dementia (BPSD) and the use of antipsychotics[J]. Pharmaceuticals (Basel), 2021, 14(3): 246. doi: 10.3390/ph14030246
    [12]
    TRINKLEY K E, STURM A M, PORTER K, et al. Efficacy and safety of atypical antipsychotics for behavioral and psychological symptoms of dementia among community dwelling adults[J]. J Pharm Pract, 2020, 33(1): 7-14. doi: 10.1177/0897190018771272
    [13]
    STURM A S, TRINKLEY K E, PORTER K, et al. Efficacy and safety of atypical antipsychotics for behavioral symptoms of dementia among patients residing in long-term care[J]. Int J Clin Pharm, 2018, 40(1): 135-142. doi: 10.1007/s11096-017-0555-y
    [14]
    PAN Y J, WU C S, GAU S S F, et al. Antipsychotic discontinuation in patients with dementia: a systematic review and meta-analysis of published randomized controlled studies[J]. Dement Geriatr Cogn Disord, 2014, 37(3/4): 125-140.
    [15]
    BALLARD C, ORRELL M, SUN Y Z, et al. Impact of antipsychotic review and nonpharmacological intervention on antipsychotic use, neuropsychiatric symptoms, and mortality in people with dementia living in nursing homes: a factorial cluster-randomized controlled trial by the well-being and health for people with dementia (WHELD) program[J]. Am J Psychiatry, 2016, 173(3): 252-262. doi: 10.1176/appi.ajp.2015.15010130
    [16]
    CUMBO E, LIGORI L D. Differential effects of current specific treatments on behavioral and psychological symptoms in patients with Alzheimer's disease: a 12-month, randomized, open-label trial[J]. J Alzheimers Dis, 2014, 39(3): 477-485. doi: 10.3233/JAD-131190
    [17]
    BALLARD C, MARGALLO-LANA M, JUSZCZAK E, et al. Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial[J]. BMJ, 2005, 330(7496): 874. doi: 10.1136/bmj.38369.459988.8F
    [18]
    VIGEN C L P, MACK W J, KEEFE R S E, et al. Cognitive effects of atypical antipsychotic medications in patients with Alzheimer's disease: outcomes from CATIE-AD[J]. Am J Psychiatry, 2011, 168(8): 831-839. doi: 10.1176/appi.ajp.2011.08121844
    [19]
    DENNIS M, SHINE L, JOHN A, et al. Risk of adverse outcomes for older people with dementia prescribed antipsychotic medication: a population based e-cohort study[J]. Neurol Ther, 2017, 6(1): 57-77. doi: 10.1007/s40120-016-0060-6
  • Cited by

    Periodical cited type(2)

    1. 姚洁,张艳妮. 喹硫平与奥氮平治疗老年性精神病的效果比较. 临床合理用药. 2025(02): 52-54+61 .
    2. 吴声辉,李桃,许世欢. 利培酮结合喹硫平治疗癫痫所致精神障碍的价值及对精神状态与血清炎性因子的影响. 中外医疗. 2024(17): 72-76 .

    Other cited types(0)

Catalog

    Article views (241) PDF downloads (23) Cited by(2)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return