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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 3^rd 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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