Meta-analysis of the effectiveness of atypical antipsychotics for the treatment of behavioural problems in persons with dementia

Department of Psychology, University of Nevada, Reno, NV 89557, USA.
Psychotherapy and Psychosomatics (Impact Factor: 9.2). 02/2007; 76(4):213-8. DOI: 10.1159/000101499
Source: PubMed


To review published reports of the usage of atypical antipsychotics for behavioural problems of dementia patients.
The electronic database Medline was searched from 1999 to 2006 with a combination of search terms including 'behavioural problems' and 'atypical antipsychotics'.
Thirteen eligible studies were included in the overall analysis. The total number of participants was 1,683, of whom 1,015 received medication and 668 received placebo. Medications studied were risperidone, olanzapine, and quetiapine. Other studies examined other types of medications, such as typical versus atypical antipsychotics, but only data for atypical antipsychotics were included in the meta-analysis. The mean effect size for 7 placebo-controlled studies was 0.45 (95% CI = 0.16-0.74) for atypical antipsychotics, and 0.32 (95% CI = 0.10-0.53) for placebo. The mean effect size of all 13 studies included in the analysis was 0.31 (95% CI = 0.08-0.54).
In general, effect sizes of atypical antipsychotics for behavioural problems are medium, and there are no statistically or clinically significant differences between atypical antipsychotics and placebo.

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    • "Such exclusive interventions, however, have less of an impact on patients' more disturbing psychotic symptoms. Historically, antipsychotic medications have been the first-line treatment for severe behavioral problems for dementia patients, which unfortunately tend to be disproportionately prescribed to elderly communities (Yury & Fisher, 2007). Because of the complicated nature of the inevitable progression of dementia and its concurrent treatment, psychological care has predominantly adopted person-centered therapies tailored specifically toward the patient's immediate emotional, behavioral, and environmental needs (Rayner et al., 2006). "
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