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Escitalopram versus risperidone for the treatment of behavioral and psychotic symptoms associated with Alzheimer's disease: a randomized double-blind pilot study

Published online by Cambridge University Press:  15 April 2011

Yoram Barak ,
Igor Plopski ,
Shelly Tadger  and
Diana Paleacu
Yoram Barak*
Affiliation:
Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Igor Plopski
Affiliation:
Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Shelly Tadger
Affiliation:
Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Diana Paleacu
Affiliation:
Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
*
Correspondence should be addressed to: Yoram Barak, MD, MHA, Director of Psychogeriatrics, Abarbanel MHC, 15 KKL Street, Bat-Yam, 59100, Israel. Phone and Fax: +972-3-5552738. Email: mdybarak@gmail.com.
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Abstract

Background: Antipsychotics are frequently used to treat psychosis, aggression and agitation in patients with Alzheimer's disease (AD), but safety warnings abound. Escitalopram was investigated since citalopram has demonstrated some effectiveness in AD. We compared escitalopram and risperidone for psychotic symptoms and agitation associated with AD.

Methods: Inpatients with AD, who had been hospitalized because of behavioral symptoms, were recruited to a six-week randomized, double-blind, controlled trial. Participants (n = 40) were randomized to once daily risperidone 1 mg or escitalopram 10 mg.

Results: The NPI total score improved in both groups. Onset was earlier in the risperidone-treated group, but improvement did not significantly differ between groups by study end. Completion rates differed for escitalopram (75%) and risperidone (55%), mainly due to adverse events. There were no adverse events in the escitalopram group, while in the risperidone group two patients suffered severe extrapyramidal symptoms and four patients suffered acute physical illness necessitating transfer to general hospital.

Conclusion: Escitalopram and risperidone did not differ in efficacy in reducing psychotic symptoms and agitation in patients with AD. Completion rates were higher for escitalopram-treated patients. Replication in larger trials with ambulatory patients is needed.

Keywords

Alzheimer's diseasepsychosisescitalopramrisperidone
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 9 , November 2011 , pp. 1515 - 1519
Copyright
Copyright © International Psychogeriatric Association 2011

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