Regular ArticlesA Pilot Randomized Trial of Carbamazepine for Behavioral Symptoms in Treatment-Resistant Outpatients with Alzheimer Disease
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Subjects and Settings
Subjects met the following inclusion criteria: NINCDS-ADRDA criteria for probable or possible AD;14 ≥55 years of age; living with a caregiver; Hachinski ischemic score ≤4; Mini-Mental State Exam (MMSE) score ≤23;15 poor response to previous neuroleptic treatment, based on caregiver report and medical records review (all subjects had been seen for an extensive length of time before participation in this study, having originally enrolled in earlier clinical trials, then followed by the clinic
RESULTS
Twenty-one subjects were entered; 9 were randomly assigned to carbamazepine, 12 to placebo. Fourteen were women; the mean age was 74.7±6.23 years (range: 63–86); seven had less than a high school education, five had completed high school, 8 had some college, and one completed college. Fifteen subjects were white, three were African-American, and three were Hispanic. No significant differences were found between treatment groups at baseline.
Sixteen subjects completed 6 weeks of the trial, with
DISCUSSION
These severely cognitively impaired individuals with AD were selected on the basis of predominant symptoms of hostility, uncooperativeness, and tension and had been treated previously with neuroleptics. Carbamazepine treatment showed a beneficial effect on clinicians' global ratings, largely because more placebo-treated subjects worsened, compared with carbamazepine-treated subjects, and because of an improvement in Hostility ratings. Three of the four dropouts in the placebo group did so
References (18)
- et al.
Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
Eligibility of Alzheimer's disease clinic patients for clinical trials
J Am Geriatr Soc
(1997) - et al.
Anticonvulsant and other non-neuroleptic treatment of agitation in dementia
J Geriatr Psychiatry Neurol
(1995) - et al.
A metaanalysis of controlled trials of neuroleptic treatment in dementia
J Am Geriatr Soc
(1990) - et al.
Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial: Risperidone Study Group
J Clin Psychiatry
(1999) - Street J, Clark WS, Gannon KS, Olanzapine reduces psychosis and behavioral disturbances associated with Alzheimer's...
- et al.
Non-neuroleptic medication in the management of agitation in Alzheimer's disease and other dementia: a selective review
Int J Geriatr Psychiatry
(1991) - et al.
Voltage-activated calcium channels: targets of anti-epileptic drug therapy?
Epilepsia
(1997) - et al.
Carbamazepine treatment of agitation in Alzheimer's outpatients refractory to neuroleptics
J Clin Psychiatry
(1990)
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Portions of these data were presented at the meeting of the American Association of Geriatric Psychiatry, Miami, FL, March 14, 2000, and at the Seventh International Conference on Alzheimer's Disease and Related Disorders, Washington, DC, July 11, 2000.
This research was supported by grants from the National Institute of Mental Health (MH01368 [to Dr. Olin], MH48759 [Dr. Schneider]), the Alzheimer's Association (898014 [Dr. Schneider]), and the Southern California Alzheimer's Disease Research Center (AG05142).