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 Recent news - Geriatrics
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        DGDispatch


        Non-aggressive Symptoms in Dementia Patients Also Respond to Risperidone: Presented at AAGP

        By Bonnie Darves

        HONOLULU, HA -- March 5, 2003 -- Patients with dementia who exhibit non-aggressive symptoms may also benefit from treatment with risperidone, according to a study presented here March 3rd at the Annual Meeting of the American Association for Geriatric Psychiatry.

        Although the efficacy of pharmacologic treatment in patients with aggressive symptoms is well documented, previous reports have suggested that non-aggressive symptoms are do not respond to treatment, the researchers said.

        The 12-week randomised, double-blind trial led by Jacobo Mintzer, MD, of the Medical University of South Carolina in Charleston, United States, followed 617 patients, predominantly female and with a mean age of 82.7 years, who resided in long-term care facilities and had a confirmed diagnosis of dementia.

        After a placebo wash-out period, the subjects received risperidone in doses ranging from 0.5 to 2 mg/day or placebo.

        The researchers assessed patients using the Cohen Mansfield Agitation Inventory (CMAI) with a focus on non-aggression behaviours such as pacing, hiding or hoarding objects, inappropriate dress and repetitious mannerism. Patients were analysed at screening and baseline, at weeks 4, 8 and 12, and at end point using.

        Mean CMAI non-aggressive scores were 38.0 at baseline.

        Patients who received either 1 mg or 2mg daily of risperidone demonstrated a significant reduction in CMAI non-aggression scores between baseline and week 12, with a mean change of –9 and –10 for the 1 mg and 2 mg risperidone groups, respectively, versus –4 for the placebo group. Patients who took 0.5 mg of risperidone demonstrated a more modest decline of –8.

        The largest decline in symptoms was seen in verbal non-aggression, which demonstrated a mean change of –4.

        Adverse events with risperidone were few, the researchers reported, although they noted that patients who took 2 mg exhibited a higher incidence of peripheral oedema and somnolence than those taking the lower doses.

        Overall, the improvement in non-aggressive symptoms appears to be related to both dose and time of exposure, Dr. Mintzer said, since the greatest decline occurred between weeks 2 and 8, while CMAI aggression scores continued to decline throughout the study.

        These study results are noteworthy, the researchers said, because earlier trials have not demonstrated a response to pharmacologic treatment in patients with non-aggressive behaviours. They added that prospective studies should be performed to confirm these results.


        [Study title: Pharmacologic Treatment Of Nonaggressive Agitation Symptoms Related To Dementia: Analysis Of 617 Patients In A Multicenter Placebo-Controlled Study]



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