[Efficacy and adverse reactions of antipsychotics for neuropsychiatric symptoms in dementia: a systematic review]
until further notice
SourceNederlands Tijdschrift voor Geneeskunde, 150, 28, (2006), pp. 1565-1573
Article / Letter to editor
Display more detailsDisplay less details
Nursing Home Medicine
Nederlands Tijdschrift voor Geneeskunde
SubjectDCN 1: Perception and Action; EBP 2: Effective Hospital Care; EBP 4: Quality of Care; IGMD 5: Health aging / healthy living; NCEBP 11: Alzheimer Centre; NCEBP 14: Cardiovascular diseases; NCEBP 4: Quality of hospital and integrated care; NCEBP 7: Effective primary care and public health; UMCN 3.2: Cognitive neurosciences
OBJECTIVE: To assess the efficacy and adverse reactions of typical and atypical antipsychotics in the treatment of neuropsychiatric symptoms in dementia, and to examine the evidence for the cerebrovascular events warning for atypical antipsychotics. DESIGN: Systematic review. METHOD: Using Medline, Cinahl, PsyclNFO, Embase and the Cochrane central register of controlled trials (1980-2005), double-blind randomized controlled trials with intention-to-treat analysis were selected, which evaluated efficacy and adverse reactions of antipsychotics in the treatment of neuropsychiatric symptoms in dementia. The studies underwent a standardised validity assessment. RESULTS: After screening 950 studies, 14 studies on the effect of haloperidol, risperidone, olanzapine, quetiapine, tiapride, loxapine and perphenazine were selected. In 7 out of 10 studies, haloperidol, risperidone and olanzapine appeared to be more effective than placebo in the treatment of aggression and psychosis. Direct comparison between typical and atypical antipsychotics revealed no statistically significant difference. The most common adverse reactions were extrapyramidal symptoms and somnolence. These adverse reactions were less frequent with low-dose risperidone than with haloperidol or olanzapine, but risperidone and olanzapine were found to be associated with a higher risk of cerebrovascular events in two studies. CONCLUSION: The efficacy of typical and atypical antipsychotics is comparable, but only low-dose risperidone seems to be associated with fewer (extrapyramidal) side effects. The adverse reactions are inadequately described in the published data and consequently the warning of an increased risk of mortality could not be confirmed.
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.