a1 Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
Objective: To review and summarize the currently available data on the use of anticonvulsant mood stabilizers (carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate) in the treatment of behavioral and psychological symptoms of dementia (BPSD); to determine whether these medications can be recommended for routine clinical use.
Methods: Literature search in five databases (PubMed, MEDLINE, EMBASE, PsychINFO and COCHRANE collaboration) and analysis of the randomized controlled double-blinded clinical trials found therein.
Results: A total of seven RCTs were identified (two for carbamazepine and five for valproate). One study showed statistically significant improvement of BPSD in the medication group in comparison to the placebo group; five studies showed no significant differences; one study showed statistically significant worsening of the symptoms in the medication group vs. placebo. The majority of the studies reported significantly more frequent adverse effects in the medication group.
Conclusion: Although clearly beneficial in some patients, anticonvulsant mood stabilizers cannot be recommended for routine use in the treatment of BPSD at the present time.
(Received July 19 2007)
(Online publication August 24 2007)
(Revised August 27 2007)
(Accepted August 28 2007)
(Online publication November 30 2007)
c1 Correspondence should be addressed to: Dr. Rajesh R. Tampi, Director, Geriatric Psychiatry Fellowship Program, Yale University School of Medicine, LV-121 Yale New Haven Psychiatric Hospital, 184 Liberty Street, New Haven, CT 06519, U.S.A. Phone: +1 203 688 9893; Fax: +1 203 688 9709. Email: [email protected].