Comparison of topiramate and risperidone for the treatment of behavioral
disturbances of patients with Alzheimer disease: a double-blind, randomized
clinical trial.
Author(s): Mowla A, Pani A.
Affiliation(s): Department of Psychiatry, Persian Gulf Bioscience Research Center, Bushehr
University of Medical Sciences, Bushehr, Iran. mowlaar@gmail.com
Publication date & source: 2010, J Clin Psychopharmacol. , 30(1):40-3
INTRODUCTION: Behavioral disturbances are determining factors in handling
patients with Alzheimer dementia. The current pharmacotherapy for behavioral
symptoms associated with dementia is not satisfactory. Our goal was to compare a
new anticonvulsant, topiramate, with a usually used medication, risperidone, for
controlling behavioral disturbances of patients with Alzheimer dementia.
METHOD: Elderly patients with a Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition diagnosis of Alzheimer disease and significant
behavioral disturbances were randomized to receive, for a period of 8 weeks, a
flexible dose of either topiramate (25-50 mg/d) or risperidone (0.5-2 mg/d).
Outcome measures were the Cohen-Mansfield Agitation Inventory, Neuropsychiatry
Inventory parts 1 and 2, and the Clinical Global Impression.
RESULT: Forty-eight patients were randomized to treatment with either topiramate
or risperidone, and 41 patients (21 of 25 in topiramate group and 20 of 23 in
risperidone group) completed the trial. Both groups showed significant
improvement in all outcome measures without important difference (Neuropsychiatry
Inventory total score P < 0.531, Z = 0.62; Cohen-Mansfield Agitation Inventory P
< 0.927, Z = 0.09; Clinical Global Impression, P < 0.654, Z = 0.48). There were
no significant changes in the cognitive status of patients (assessed by
Mini-Mental Status Examination) taking topiramate or risperidone during the
trial.
CONCLUSION: Treatment with a low dose of topiramate (25-50 mg/d) demonstrated a
comparable efficacy with risperidone in controlling behavioral disturbances of
patients with Alzheimer dementia.
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