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Risperidone More Effective than Conventional Neuroleptics in Reducing Dementia Symptoms: Presented at AAGP

By Bonnie Darves

HONOLULU, HA -- March 5, 2003 -- A large multicentre study has produced new evidence that patients with dementia who respond poorly to treatment with conventional neuroleptic agents may improve after switching to risperidone.

Researchers from the Munich Technical University and Janssen-Cilag GmbH, in Neuss, Germany, reported their findings here March 3^rd at the Annual Meeting of the American Association for Geriatric Psychiatry.

Conventional neuroleptics are prescribed commonly in Germany to treat the behavioural and psychological symptoms of dementia (BPSD), said lead researchers Suzanne Schwalen, MD, of Janssen-Cilag GmbH. But low response rates and undesirable side effects such as extrapyramidal symptoms have prompted discontinuance of treatment.

Recent clinical trials showed risperidone reduces aggression and agitation often seen in patients with dementia without the high rates of side effects associated with the conventional neuroleptics melperone, haloperidol and pipamperdone.

In the 8-week prospective study of 4,499 patients, mean age 81 years, treated with risperidone, researchers performed a post hoc analysis of 680 patients who had discontinued taking one of the three conventional neuroleptics because of side effects or lack of efficacy. Before the switch to risperidone, all patients were experiencing moderate BPSD and mild delusions. Mean baseline scores were 1.5 to 2.5 for primary BPSD symptoms measured -- aggression, agitation, mistrust, social withdrawal, impaired sleep-wake cycle and delusions.

After the switch to low-dose risperidone, BPSD severity decreased significantly to between 0.5 and 1 on all measures based on physician evaluation. Dr. Schwalen also noted that Global Impression of Change scores as evaluated by physicians, relatives or caregivers improved in more than 90% of patients who had switched to risperidone, and that side effects were minimal, affecting 7.7% of all patients who received risperidone.

Patients experienced no significant changes in heart rate, weight or blood pressure while on risperidone.

The study's results, when considered in conjunction with those of previous trials, suggest that risperidone should be considered as a first-line treatment for BPSD, the researchers concluded.


[Study title: Successful Treatment Of Bpsd With Risperidone After Switching From Conventional Neuroleptics]

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