Review: atypical antipsychotics may be useful in treating behavioural and psychological symptoms of dementia but cause adverse effects

Lee PE, Gill SS, Freedman M, et al . Atypical antipsychotic drugs in the treatment of behavioural and psychological symptoms of dementia: systematic review. BMJ 2004;329:75–8. [OpenUrl][1][Abstract/FREE Full Text][2] 
 Q Do atypical antipsychotic drugs attenuate behavioural and psychological symptoms of dementia in elderly people? ### ![Graphic][3] Design: Systematic review. ### ![Graphic][4] Data sources: MEDLINE, EMBASE, and the Cochrane Library databases (searched to September 2003) plus hand searches and contact with experts. ### ![Graphic][5] Study selection and analysis: Double blind randomised controlled trials assessing atypical antipsychotic drugs for behavioural and psychological symptoms of dementia (BPSD) (clozapine, risperidone, olanzapine, and quetiapine). Two reviewers independently assessed quality and abstracted information on participant demographics, duration, dosage, efficacy, and adverse events. ### ![Graphic][6] Outcomes: Efficacy was measured using the Behavioural Pathology in Alzheimer’s Disease Score (BEHAVE-AD), the Cohen-Mansfield Agitation Inventory (CMAI) or the Neuropsychiatric Inventory - Nursing Home version (NPI-NH), or combinations of the above. Adverse events were noted, particularly extrapyramidal symptoms (Extrapyramidal Symptom Rating scale and the Simpson-Angus scale). Participant characteristics, study length, and dosage were also recorded. Five trials met inclusion criteria (n = 1570; … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.38125.465579.55%26rft_id%253Dinfo%253Apmid%252F15194601%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=329/7457/75&atom=%2Febmental%2F8%2F1%2F16.atom [3]: /embed/inline-graphic-1.gif [4]: /embed/inline-graphic-2.gif [5]: /embed/inline-graphic-3.gif [6]: /embed/inline-graphic-4.gif