Am J Psychiatry 155:54-61, January 1998
© 1998 American Psychiatric Association
Efficacy and Tolerability of Carbamazepine for Agitation and Aggression in Dementia
Pierre N. Tariot, M.D.,
Rosemary Erb, R.N., B.S.N.,
Carol Ann Podgorski, Ph.D.,
Christopher Cox, Ph.D.,
Shirish Patel, M.D.,
Laura Jakimovich, M.S., R.N., and
Carrie Irvine, B.A.
OBJECTIVE: The efficacy, safety, and tolerability of carbamazepine in the treatment of agitation and aggression associated with dementia were assessed. METHOD: In a 6-week, randomized, multisite, parallel-group study of 51 nursing home patients with agitation and dementia, individualized doses of carbamazepine were compared with placebo. Except for a physician monitor and a pharmacist, all participants were blind to treatment. The primary outcome measures were the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) global improvement rating. Secondary measures included measures of behavior, aggression, cognition, functional status, staff time, safety, and tolerability. Intent-to-treat analysis was performed. RESULTS: The modal carbamazepine dose at 6 weeks was 300 mg/day, and a mean serum level of 5.3 µg/ml was achieved. The study was terminated after a planned interim analysis showed that carbamazepine provided more benefit than did placebo. Over 6 weeks the mean total BPRS score decreased 7.7 points for the carbamazepine group and 0.9 for the placebo group, and the weekly scores showed a gradual divergence between the two groups. CGI ratings showed global improvement in 77% of the patients taking carbamazepine and 21% of those taking placebo. Secondary analyses confirmed that the positive changes were due to decreased agitation and aggression. The drug was generally well tolerated, and no change in cognition or functional status occurred. The perception of staff time needed to manage agitation showed a decrease for carbamazepine but not placebo. CONCLUSIONS: This controlled study showed significant short-term efficacy of carbamazepine for agitation with generally good safety and tolerability. (Am J Psychiatry 1998; 155:54–61)
This article has been cited by other articles:
|
|
|
|
 
A. Bourbonnais and F. Ducharme
Screaming in elderly persons with dementia: A critical review of the literature
Dementia,
May 1, 2008;
7(2):
205 - 225.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Ballard
Agitation and Psychosis in Dementia
Am J Geriatr Psychiatry,
November 1, 2007;
15(11):
913 - 917.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Hollis, D. Grayson, L. Forrester, H. Brodaty, S. Touyz, and R. Cumming
Antipsychotic Medication Dispensing and Risk of Death in Veterans and War Widows 65 Years and Older
Am J Geriatr Psychiatry,
November 1, 2007;
15(11):
932 - 941.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
References
PsychiatryOnline CME,
May 1, 2007;
2007(1):
2 - 2.
[Full Text]
|
|
|
|
|
|
|
R. Leonard, M. E. Tinetti, H. G. Allore, and M. A. Drickamer
Potentially modifiable resident characteristics that are associated with physical or verbal aggression among nursing home residents with dementia.
Arch Intern Med,
June 26, 2006;
166(12):
1295 - 1300.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. N. Tariot, R. Raman, L. Jakimovich, L. Schneider, A. Porsteinsson, R. Thomas, J. Mintzer, R. Brenner, K. Schafer, L. Thal, et al.
Divalproex Sodium in Nursing Home Residents With Possible or Probable Alzheimer Disease Complicated by Agitation: A Randomized, Controlled Trial
Am J Geriatr Psychiatry,
November 1, 2005;
13(11):
942 - 949.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Cummings
Neuropsychiatric and behavioral alterations and their management in moderate to severe Alzheimer disease
Neurology,
September 27, 2005;
65(6_suppl_3):
S18 - S24.
[Full Text]
|
|
|
|
|
|
|
C. Haw and J. Stubbs
A survey of the off-label use of mood stabilizers in a large psychiatric hospital
J Psychopharmacol,
July 1, 2005;
19(4):
402 - 407.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Tritt, C. Nickel, C. Lahmann, P. K. Leiberich, W. K. Rother, T. H. Loew, and M. K. Nickel
Lamotrigine treatment of aggression in female borderline-patients: a randomized, double-blind, placebo-controlled study
J Psychopharmacol,
May 1, 2005;
19(3):
287 - 291.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Ballard, M. Margallo-Lana, E. Juszczak, S. Douglas, A. Swann, A. Thomas, J. O'Brien, A. Everratt, S. Sadler, C. Maddison, et al.
Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial
BMJ,
April 16, 2005;
330(7496):
874.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. M. Sink, K. F. Holden, and K. Yaffe
Pharmacological Treatment of Neuropsychiatric Symptoms of Dementia: A Review of the Evidence
JAMA,
February 2, 2005;
293(5):
596 - 608.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Cummings
Alzheimer's Disease
N. Engl. J. Med.,
July 1, 2004;
351(1):
56 - 67.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. L. Maher Jr
The Pharmacological Approach of Behavioral Disturbances in Dementia
Journal of Pharmacy Practice,
April 1, 2004;
17(2):
129 - 132.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. P. Porsteinsson, P. N. Tariot, L. J. Jakimovich, N. Kowalski, C. Holt, R. Erb, and C. Cox
Valproate Therapy for Agitation in Dementia: Open-Label Extension of a Double-Blind Trial
Am J Geriatr Psychiatry,
August 1, 2003;
11(4):
434 - 440.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Steinberg, J.-M. Sheppard, J. T. Tschanz, M. C. Norton, D. C. Steffens, J. C.S. Breitner, and C. G. Lyketsos
The Incidence of Mental and Behavioral Disturbances in Dementia: The Cache County Study
J Neuropsychiatry Clin Neurosci,
August 1, 2003;
15(3):
340 - 345.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. G. Lyketsos, L. DelCampo, M. Steinberg, Q. Miles, C. D. Steele, C. Munro, A. S. Baker, J.-M. E. Sheppard, C. Frangakis, J. Brandt, et al.
Treating Depression in Alzheimer Disease: Efficacy and Safety of Sertraline Therapy, and the Benefits of Depression Reduction: The DIADS
Arch Gen Psychiatry,
July 1, 2003;
60(7):
737 - 746.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. T. Grossberg and A. K. Desai
Management of Alzheimer's Disease
J. Gerontol. A Biol. Sci. Med. Sci.,
April 1, 2003;
58(4):
M331 - 353.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. LAWLOR
Managing behavioural and psychological symptoms in dementia
The British Journal of Psychiatry,
December 1, 2002;
181(6):
463 - 465.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Ryan, S. W. Kidder, L. A. Daiello, and P. N. Tariot
Mental Health Services in Nursing Homes: Psychopharmacologic Interventions in Nursing Homes: What Do We Know and Where Should We Go?
Psychiatr Serv,
November 1, 2002;
53(11):
1407 - 1413.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. G. Lyketsos, O. Lopez, B. Jones, A. L. Fitzpatrick, J. Breitner, and S. DeKosky
Prevalence of Neuropsychiatric Symptoms in Dementia and Mild Cognitive Impairment: Results From the Cardiovascular Health Study
JAMA,
September 25, 2002;
288(12):
1475 - 1483.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Scott, R. M. Lawrence, A. Duggal, C. Darwin, E. Brooks, and G. Christodoulou
Prescribing patterns for psychotic and behavioural symptoms in dementia: a national survey
Psychiatr. Bull.,
August 1, 2002;
26(8):
288 - 290.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Cummings and G. Cole
Alzheimer Disease
JAMA,
May 8, 2002;
287(18):
2335 - 2338.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Boyd
Behavioral Disturbances Associated with Dementia: Nursing Implications
Journal of the American Psychiatric Nurses Association,
December 1, 2001;
7(6):
S14 - S22.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. T. Olin, L. S. Fox, S. Pawluczyk, N. A. Taggart, and L. S. Schneider
A Pilot Randomized Trial of Carbamazepine for Behavioral Symptoms in Treatment-Resistant Outpatients with Alzheimer Disease
Am J Geriatr Psychiatry,
November 1, 2001;
9(4):
400 - 405.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. G. Moeller, E. S. Barratt, D. M. Dougherty, J. M. Schmitz, and A. C. Swann
Psychiatric Aspects of Impulsivity
Am J Psychiatry,
November 1, 2001;
158(11):
1783 - 1793.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. P. Porsteinsson, P. N. Tariot, R. Erb, C. Cox, E. Smith, L. Jakimovich, J. Noviasky, N. Kowalski, C. J. Holt, and C. Irvine
Placebo-Controlled Study of Divalproex Sodium for Agitation in Dementia
Am J Geriatr Psychiatry,
February 1, 2001;
9(1):
58 - 66.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
N. Herrmann and S. E. Black
Behavioral disturbances in dementia: Will the real treatment please stand up?
Neurology,
November 14, 2000;
55(9):
1247 - 1248.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gardner, L. Ditmanson, R. W Garrett, T. Luu, and F. Meiling
Anticonvulsant Use in Treating Dementia-Related Agitation
Journal of Pharmacy Practice,
August 1, 2000;
13(4):
308 - 315.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. E. Chatham Showalter and D. N. Kimmel
Agitated Symptom Response to Divalproex Following Acute Brain Injury
J Neuropsychiatry Clin Neurosci,
August 1, 2000;
12(3):
395 - 397.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
C. G. Lyketsos, M. Steinberg, J. T. Tschanz, M. C. Norton, D. C. Steffens, and J. C.S. Breitner
Mental and Behavioral Disturbances in Dementia: Findings From the Cache County Study on Memory in Aging
Am J Psychiatry,
May 1, 2000;
157(5):
708 - 714.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
D. M. Roane, T. E. Feinberg, L. Meckler, C. R. Miner, A. Scicutella, and R. N. Rosenthal
Treatment of Dementia-Associated Agitation With Gabapentin
J Neuropsychiatry Clin Neurosci,
February 1, 2000;
12(1):
40 - 43.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. Mayeux and M. Sano
Treatment of Alzheimer's Disease
N. Engl. J. Med.,
November 25, 1999;
341(22):
1670 - 1679.
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. L. Lopez, S. R. Wisniewski, J. T. Becker, F. Boller, and S. T. DeKosky
Psychiatric Medication and Abnormal Behavior as Predictors of Progression in Probable Alzheimer Disease
Arch Neurol,
October 1, 1999;
56(10):
1266 - 1272.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Draper
Practical Geriatrics: The Diagnosis and Treatment of Depression in Dementia
Psychiatr Serv,
September 1, 1999;
50(9):
1151 - 1153.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. A. Rummans, E. C. Lauterbach, C. E. Coffey, D. R. Royall, J. L. Cummings, S. Salloway, J. Duffy, and D. Kaufer
Pharmacologic Efficacy in Neuropsychiatry: A Review of Placebo-Controlled Treatment Trials
J Neuropsychiatry Clin Neurosci,
May 1, 1999;
11(2):
176 - 189.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
OTHER ARTICLES NOTED
Evid. Based Ment. Health,
August 1, 1998;
1(3):
67 - 67.
[Full Text]
|
|
|
|
|
|
|
Another Alternative for Agitation and Dementia
Journal Watch Women's Health,
February 1, 1998;
1998(201):
21 - 21.
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1998
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
