TY  - JOUR
PY  - 2015//
TI  - Efficacy and safety of atypical antipsychotic drug treatment for dementia: a systematic review and meta-analysis
JO  - Alzheimer's research and therapy
A1  - Tan, Lin
A1  - Tan, Lan
A1  - Wang, Hui-Fu
A1  - Wang, Jun
A1  - Tan, Chen-Chen
A1  - Tan, Meng-Shan
A1  - Meng, Xiang-Fei
A1  - Wang, Chong
A1  - Yu, Jin-Tai
SP  - e20
EP  - e20
VL  - 7
IS  - 1
N2  - INTRODUCTION: A wide variety of atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone and clozapine) are widely used in the management of neuropsychiatric symptoms, which are commonly seen in dementia, but results from randomised controlled trials (RCTs) on the efficacy and safety of these agents are conflicting. We aimed to quantify the efficacy and safety of atypical antipsychotic drugs on neuropsychiatric symptoms in dementia patients. <br><br>METHODS: PubMed, EMBASE, the Cochrane Controlled Trials Register and the Cochrane Database of Systematic Reviews for reports published before August 2014 were searched for eligible randomized controlled trials of atypical antipsychotic drugs therapy in patients with psychotic symptoms of dementia. Two reviewers independently assessed the quality of the trials and extracted information. <br><br>RESULTS: Overall, 23 relevant RCTs with 5,819 participants were identified. This meta-analysis demonstrated a significant efficacy of atypical antipsychotics on psychiatric symptoms and cognitive functions compared to placebo. In the meta-analysis, the weighted mean differences (WMDs) in change scores for psychiatric symptoms were in favor of aripiprazole (-4.4, 95% confidence interval (CI) - 7.04 to -1.77) and risperidone (-1.48, 95% CI -2.35 to -0.61) compared to placebo. In cognitive effects, WMDs in change scores for the Clinical Global Impression-Change (CGI-C) were in favor of aripiprazole, risperidone, olanzapine and quetiapine which ranged from a -0.30 points mean difference (95% CI:-0.59 to -0.01) in the aripiprazole trials to -0.43 (95% CI:-0.62 to -0.25) in the risperidone group. Patients receiving atypical antipsychotics showed no difference in risk for injuries or falls (P > 0.05), significantly higher risks (P < 0.05) for somnolence, urinary tract infection, edema and abnormal gait. However, there was no significant evidence for death reported. <br><br>CONCLUSION: Aripiprazole and risperidone are able to improve psychiatric symptoms and slow decline in cognition function at average 12 weeks in patients with neuropsychiatric symptoms of dementia. However, high adverse events may offset the efficacy of atypical antipsychotics in dementia.<p />  <p>Language: en</p>
LA  - en
SN  - 1758-9193
UR  - http://dx.doi.org/10.1186/s13195-015-0102-9
ID  - ref1
ER  -