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Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia: an open randomized trial
Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.ORCID iD: 0000-0001-6863-6679
Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
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2014 (English)In: The American journal of geriatric psychiatry, ISSN 1064-7481, E-ISSN 1545-7214, Vol. 22, no 4, p. 341-248Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine the effects of galantamine and risperidone on neuropsychiatric symptoms in dementia (NPSD) and global function.

METHODS: Using a randomized, controlled and open-blind, one-center trial at an in- and outpatient clinic at a university hospital, we studied 100 adults with probable dementia and NPSD. Participants received galantamine (N = 50, target dose 24 mg) or risperidone (N = 50, target dose 1.5 mg) for 12 weeks. The primary outcome was effects on NPSD assessed by the Neuropsychiatric Inventory (NPI). Secondary measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Clinical Global Impression, and Simpson Angus scales. All tests were performed before and after treatment.

RESULTS: Outcome measures were analyzed using analysis of covariance. Ninety-one patients (67% women, mean age 79 ± 7.5 years) with initial NPI score of 51.0 (± 25.8) and MMSE of 20.1 (± 4.6) completed the trial. Both galantamine and risperidone treatments resulted in improved NPSD symptoms and were equally effective in treating several NPI domains. However, risperidone showed a significant treatment advantage in the NPI domains irritation and agitation, F(1, 97) = 5.2, p = 0.02. Galantamine treatment also ameliorated cognitive functions where MMSE scores increased 2.8 points compared with baseline (95% confidence interval: 1.96-3.52). No treatment-related severe side effects occurred.

CONCLUSIONS: These results support that galantamine, with its benign safety profile, can be used as first-line treatment of NPSD symptoms, unless symptoms of irritation and agitation are prominent, where risperidone is more efficient.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 22, no 4, p. 341-248
Keywords [en]
NPI, NPSD, Neuropsychiatric symptoms, dementia, galantamine, risperidone
National Category
Geriatrics Neurology
Identifiers
URN: urn:nbn:se:oru:diva-74055DOI: 10.1016/j.jagp.2013.05.005ISI: 000336086700005PubMedID: 24035407Scopus ID: 2-s2.0-84898622517OAI: oai:DiVA.org:oru-74055DiVA, id: diva2:1313966
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-06-18Bibliographically approved

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Freund-Levi, Yvonne

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