Comparative efficacy of risperidone versus haloperidol on behavioural and psychological symptoms of dementia

Background Behavioural and psychological symptoms of dementia (BPSD) cannot be regarded as a single clinical syndrome, but rather as a heterogeneous group of symptoms, each of which can be considered as possible targets for therapy. Objective To compare the efficacy of risperidone and haloperidol on...

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Bibliographic Details
Published in:International journal of geriatric psychiatry 2006-07, Vol.21 (7), p.654-660
Main Authors: Suh, Guk-Hee, Greenspan, Andrew J., Choi, Sung-Ku
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
agitation
Antipsychotic Agents - therapeutic use
anxiety
Anxiety Disorders - diagnosis
Anxiety Disorders - epidemiology
Anxiety Disorders - psychology
Behavior
BPSD
Comparative studies
Cross-Over Studies
Dementia
Dementia - epidemiology
Dementia - psychology
diurnal rhythm
Double-Blind Method
Drug therapy
Female
Geriatric psychiatry
haloperidol
Haloperidol - therapeutic use
Humans
Male
mannerism
Mood Disorders - diagnosis
Mood Disorders - epidemiology
Mood Disorders - psychology
negativism
Nursing Homes
Psychomotor Agitation - drug therapy
Psychomotor Agitation - epidemiology
Psychotropic drugs
risperidone
Risperidone - therapeutic use
sleep
Treatment Outcome
wandering
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Summary:Background Behavioural and psychological symptoms of dementia (BPSD) cannot be regarded as a single clinical syndrome, but rather as a heterogeneous group of symptoms, each of which can be considered as possible targets for therapy. Objective To compare the efficacy of risperidone and haloperidol on specific manifestations of BPSD. Methods A post‐hoc analysis was conducted using data from an 18‐week, randomized, double‐blind, crossover head‐to‐head trial of risperidone vs haloperidol in treating 114 nursing‐home residents with BPSD. Dependent variables were item scores of the Korean versions of the Behavioural Pathology in Alzheimer's Disease Rating Scale (BEHAVE‐AD‐K) and Cohen‐Mansfield Agitation Inventory (CMAI‐K). Results On the BEHAVE‐AD‐K, risperidone was significantly more effective than haloperidol in treating wandering (p = 0.0496), agitation (p = 0.0091), diurnal rhythm disturbances (p = 0.0137), anxiety regarding upcoming events (p = 0.0002), and other anxieties (p = 0.0088). On the CMAI‐K, risperidone was significantly more effective in treating physical sexual advances (p = 0.0202), pacing and aimless wandering (p = 0.0123), intentional falling (p = 0.0398), hoarding things (p = 0.0499), performing repetitious mannerisms (p = 0.0048), repetitive sentence or questions (p = 0.0025), complaining (p = 0.0101), and negativism (p = 0.0027). Haloperidol was not significantly superior to risperidone on any individual item in either scale. Conclusions When comparing treatment effects on individual symptoms frequently occurring in patients with dementia, risperidone significantly improved symptoms of agitation, wandering, diurnal rhythm disturbance and anxieties, among other symptoms, compared with haloperidol. Copyright © 2006 John Wiley & Sons, Ltd.
ISSN:0885-6230
1099-1166
DOI:10.1002/gps.1542