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ID: 10440
Title:Pharmacological Treatment of Neuropsychiatric Symptoms: A Review of the Evidence.
Publication Year: 2005.
Format(s): Journal Article , Review
Language(s): English
Audience(s): Physicians , Psychiatrists , Neurologists , Psychiatrists
Author(s): Sink, K.M.; , Holden, K.F.; , Yaffe, K.
Source: JAMA. Journal of the American Medical Association. 293(5): 596-608. February 2, 2005.

Abstract: The purpose of this study was to evaluate the efficacy of pharmacological agents used in the treatment of neuropsychiatric symptoms of dementia, based on a systematic review of the literature. For typical antipsychotics, two meta-analyses and two randomized controlled trials (RCTs) that met inclusion criteria were found. Generally, no difference among specific agents was found, efficacy was small at best, and adverse effects were common. Six RCTs with atypical antipsychotics were included, and these results showed modest, statistically significant efficacy of olanzapine and risperidone, with minimal adverse effects at lower doses. Atypical antipsychotics are associated with an increased risk of stroke. There have been no RCTs designed to directly compare the efficacy of typical and atypical antipsychotics. Five trials of antidepressants were included; these results showed no efficacy for treating neuropsychiatric symptoms other than depression, with the exception of one study of citalopram. For mood stabilizers, three RCTs investigating valproate showed no efficacy. Two small RCTs of carbamazepine had conflicting results. Two meta-analyses and six RCTs of cholinesterase inhibitors generally showed small but statistically significant efficacy. Two RCTs of memantine also had conflicting results for treatment of neuropsychiatric symptoms. 1 figure, 6 tables, 75 references. (AA-M).

Availability: Available from the American Medical Association, Subscriber Services Center, P.O. Box 10946, Chicago, IL 60610-0946. (800) 262-2350; (312) 670-7827. E-mail: ama-subs@ama-assn.org. Free online access at http://jama.ama-assn.org.
Major Descriptor(s): DEMENTIA , ALZHEIMERS-DISEASE , MENTAL-DISORDERS , PSYCHOTIC-DISORDERS , PSYCHOTROPIC-DRUGS , DRUG-THERAPY , DEPRESSION , ANTIDEPRESSANTS , CHOLINESTERASE-INHIBITORS , LITERATURE-REVIEWS
Minor Descriptor(s): MEMANTINE , RESEARCH-NEEDS

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