engleski

Treatment of agitated patienets with Alzheimer's dementia

Objectives: to compare changes in symptoms of agitation in the groups of patients with Alzheimer's dementia treated with typical and atypical antipsychotics, measured by Agitated Behavior Scale. Methods: Agitated Behavior Scale was used in order to assess sympto¬matic improvement in two groups of agitated patients with Alzheimer demen¬tia. Each group was comprised of 15 patients (8 male 7 female (typical antipsy¬chotics) ; 7 male, 8 female (atypical antipsychotics)). Patients were assessed during period of 1 month of continuous treatment with antipsychotics. All patients were inpatients. In the group treated with typical antipsychotics 10 patients were treated with haloperidol (2-6 mg) and 5 patients with flufe- nazine (2, 5-7, 5 mg). In the group treated with atypical antipsychotics 6 patients were treated with quetiapine (100-300 mg), 5 patients were treated with olanzapine (5-10 mg) and 4 patients with risperidone (2-4 mg). Patients began therapy with antipsychotics after being admitted on our Clinical department. The first assessment (baseline) was made upon the inclu¬sion. In the first 5 days, assessments were performed on the daily basis. After that, patients were assessed every week. Beside antipsychotics, patients were treated with hypnotics. There were 3 cases of therapy discontinuation due to side effects (extrapyramidal symptoms, hypotension, weight gain). The patients who dis¬continued the therapy were assessed on the last day of therapy, and their results were added to the results of other patients. Results: Improvements in symptoms occurred during first 5 days of treatment in both groups, measured by Agitated Behavior Scale (total score). During this period, in the group treated with atypical antipsychotics improve¬ments occurred regarding impulsive, impatient, low tolerance for pain or frus¬tration, violent and/or threatening violence toward people or property, explo¬sive and/or unpredictable anger, restlessness and pacing. During the same period, in the group treated with typical antipsychotics improvements occurred regarding impulsive, impatient, low tolerance for pain or frustration, violent and/or threatening violence toward people or property. After one month of therapy, clinically significant improvement was present in the group treated with atypical antipsychotics regarding impulsive, impatient, low toler¬ance for pain or frustration, violent and/or threatening violence toward people or property, explosive and/or unpredictable anger, restlessness and pacing, rocking, rubbing, moaning or other self-stimulating behavior. In the same period of time in the group treated with typical antipsychotics improvements have occurred regarding impulsive, impatient, low tolerance for pain or frus¬tration, violent and/or threatening violence toward people or property, explo¬sive and/or unpredictable anger. Conclusion: the presented study was performed before Food and drug administration (FDA) came up with the warning regarding use of atypical antipsychotics in elderly patients. No side effects mentioned in the FDA's warning emerged during our study. Both treatments with typical and atypical antipsychotics have proved to be good choice in agitated patients with Alzheimer dementia. Treatment with atypical antipsychotics was more suc¬cessful according to the Agitated Behavior Scale.

Alzheimer's disease ; dementia ; agitation ; antipsychotics ; Agiteted Behaviour Scale

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