Novel antipsychotics for agitation in dementia: a systematic review
Pwee K H, Shukla V K, Herrmann N, Skidmore B
Record ID 32003000474
English, French
Authors' objectives:
This assessment critically examines the evidence on the efficacy and safety of novel antipsychotics as compared to placebo and as compared to conventional antipsychotics, for the management of patients with dementia-associated agitation (DAA).
Authors' recommendations:
The efficacy of intramuscular olanzapine for the rapid treatment of DAA was found to be comparable to that of lorazepam (a benzodiazepine), and better than that of placebo, for institutionalized elderly patients. Adverse events at 24 hours were the same for all three patient groups.
Over the longer term (6 to 12 weeks), the evidence regarding the efficacy, measured using behavioural scales in elderly patients, of olanzapine and risperidone compared to placebo was variable: some trials showed benefit and some did not. Both drugs increased some types of side effects.
In two 12-week trials in elderly patients with DAA, risperidone was compared to the conventional antipsychotic agent haloperidol. Efficacy was similar with both drugs. However, haloperidol increased the incidence of extrapyramidal symptoms significantly.
DAA is a long-term condition often requiring treatment for years, yet trials have been relatively short (6 to 12 weeks).
Health Canada has recently advised that elderly dementia patients on risperidone may have an increased risk of cerebrovascular adverse events.
Novel antipsychotics are expensive drugs, relative to more established alternatives. Cost-effectiveness analyses may clarify relative costs and benefits.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
https://www.ccohta.ca/
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Antipsychotic Agents
- Dementia
- Psychomotor Agitation
Contact
Organisation Name:
Canadian Coordinating Office for Health Technology Assessment
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Coordinating Office for Health Technology Assessment (CCOHTA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.