Dott. Carlo Sebastiano Tadeo
Risperidone sicuro ed efficace per i problemi comportamentali e psicologici nella demenza
Sommario: Un studio presentato all'ultimo Congresso mondiale di Neurologia ha dimostrato l'efficacia e la sicurezza d'uso del Risperidone nei disturbi comportamentali nei pazienti con demenza. In questi pazienti spesso si manifestano aggressività, agitazione, alterazione del ritmo sonno-veglia. Il Risperidone è un neurolettico atipico, causa minori effetti collaterali di tipo extrapiramidale rispetto ai neurolettici più vecchi. Lo studio è stato condotto su 4499 pazienti con una età media di 81 anni. I sintomi si sono ridotti del 40% in media e solo il 2,4% dei pazienti hanno interrotto la terapia per inefficacia o eventi avversi.
LONDON, ENGLAND -- June 18, 2001 -- Risperidone is a safe and effective treatment for behavioral and psychological symptoms of dementia, according to a post-marketing study presented today at the 17th World Congress of Neurology here.
The behavioral and psychological symptoms associated with dementia cause significant caregiver burden, noted the study author, Alexander Kurz of the Department of Psychiatry and Psychotherapy at Technical University in Munich, Germany.
Alzheimer's disease symptoms include aggression, agitation, mistrust, social withdrawal, delusion, and disruption of the sleep-wake cycle.
Risperidone is one of the atypical antipsychotics, which cause fewer extrapyramidal side effects than older drugs.
In this prospective, open-label study in Germany, Dr. Kurz and colleagues examined the safety and efficacy of risperidone in 4,499 patients with behavioral and psychological symptoms from dementia. Patients had a mean age of 81 years, were 71 percent female, and had at least mild symptoms. Forty-four percent lived in a nursing home, and 22 percent with a spouse.
Risperidone treatment led to significant improvement in behavioral and psychological symptoms within one week, with an approximate 40 percent reduction in severity of each of the six symptoms as assessed on a five-point severity scale (p<0.001).
Further improvement was seen by the final visit, for a total of approximately 65 percent reduction in symptoms.
Clinical and Caregiver Global Assessment indicated marked improvement in approximately half of patients, and moderate improvement in about 40 percent. Extrapyramidal symptoms were seen in less than 1 percent of patients.
One hundred patients (2.4 percent) withdrew due to insufficient efficacy, and a similar fraction due to adverse events. Final mean dose was 1.6 mg/day.
Dr. Kurz noted that a consensus conference of German geriatric psychiatry groups has recommended atypical antipsychotics for treatment of the behavioral and psychological symptoms of dementia.
Risperidone's safety and ability to improve symptoms recommend it as "the drug of choice for this indication," he concluded.
The study, "Risperidone (Risperdal) for the Treatment of Behavioural and Psychological Symptoms in Dementia (BPSD): Results of a Survey with 4499 Patients: was supported by Jannsen-Cilag.
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