Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia

Walter G. Deberdt, Maurice W. Dysken, Stephen A. Rappaport, Peter D. Feldman, Carrie A. Young, Donald P. Hay, Deborah L. Lehman, Martin Dossenbach, Elisabeth K. Degenhardt, Alan Breier

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Objective: The authors compared efficacy of olanzapine versus placebo and risperidone as measured by the Neuropsychiatric Inventory and Clinical Global Impression-Severity of Psychosis scale in patients with dementia-related psychosis. Methods: Patients with moderate-to-severe psychotic symptoms associated with dementia were recruited from outpatient or residential settings and randomly assigned to 10-week, double-blind, flexible-dose treatment with olanzapine (N = 204; 2.5 mg-10 mg/day; mean: 5.2 mg/ day), risperidone (N = 196; 0.5 mg-2 mg/day; mean: 1.0 mg/day) or placebo (N = 94). Results: Most measures of neuropsychiatric functioning improved in all treatment groups, including the placebo group, and no significant treatment differences occurred. Overall discontinuation was lowest in the placebo group, and the olanzapine group had a significantly higher incidence of discontinuation due to adverse events (16.2%) relative to placebo (3.2%) and risperidone (8.7%) groups. Treatment-emergent extra-pyramidal symptoms were more numerous for risperidone- than placebo- or olanzapine-treated patients. Abnormally high prolactin levels occurred in 78.0% of risperidone patients, compared with 16.7% for olanzapine and 5.0% for placebo. The incidence of weight gain greater than 7% from baseline was higher in the olanzapine group relative to risperidone, but neither active-treatment group showed a statistical difference from placebo (1.1%). No other statistically significant and clinically relevant differences were seen for any other vital sign, electrocardiographic measure, or laboratory hematology and chemistry, including glucose, except for cholesterol, which decreased from baseline to endpoint in both active-treatment groups. Conclusions: Patients' neuropsychiatric functioning improved with olanzapine, risperidone, and placebo treatment. There was a substantial response in the placebo group, and no significant differences emerged among treatments.

Original languageEnglish (US)
Pages (from-to)722-730
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Volume13
Issue number8
DOIs
StatePublished - 2005

Fingerprint

olanzapine
Risperidone
Psychotic Disorders
Dementia
Placebos
Therapeutics
Vital Signs
Incidence
Hematology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

Cite this

Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia. / Deberdt, Walter G.; Dysken, Maurice W.; Rappaport, Stephen A.; Feldman, Peter D.; Young, Carrie A.; Hay, Donald P.; Lehman, Deborah L.; Dossenbach, Martin; Degenhardt, Elisabeth K.; Breier, Alan.

In: American Journal of Geriatric Psychiatry, Vol. 13, No. 8, 2005, p. 722-730.

Research output: Contribution to journalArticle

Deberdt, Walter G. ; Dysken, Maurice W. ; Rappaport, Stephen A. ; Feldman, Peter D. ; Young, Carrie A. ; Hay, Donald P. ; Lehman, Deborah L. ; Dossenbach, Martin ; Degenhardt, Elisabeth K. ; Breier, Alan. / Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia. In: American Journal of Geriatric Psychiatry. 2005 ; Vol. 13, No. 8. pp. 722-730.
@article{6fbd16aa925c4611ae7e071dc2da3fb2,
title = "Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia",
abstract = "Objective: The authors compared efficacy of olanzapine versus placebo and risperidone as measured by the Neuropsychiatric Inventory and Clinical Global Impression-Severity of Psychosis scale in patients with dementia-related psychosis. Methods: Patients with moderate-to-severe psychotic symptoms associated with dementia were recruited from outpatient or residential settings and randomly assigned to 10-week, double-blind, flexible-dose treatment with olanzapine (N = 204; 2.5 mg-10 mg/day; mean: 5.2 mg/ day), risperidone (N = 196; 0.5 mg-2 mg/day; mean: 1.0 mg/day) or placebo (N = 94). Results: Most measures of neuropsychiatric functioning improved in all treatment groups, including the placebo group, and no significant treatment differences occurred. Overall discontinuation was lowest in the placebo group, and the olanzapine group had a significantly higher incidence of discontinuation due to adverse events (16.2{\%}) relative to placebo (3.2{\%}) and risperidone (8.7{\%}) groups. Treatment-emergent extra-pyramidal symptoms were more numerous for risperidone- than placebo- or olanzapine-treated patients. Abnormally high prolactin levels occurred in 78.0{\%} of risperidone patients, compared with 16.7{\%} for olanzapine and 5.0{\%} for placebo. The incidence of weight gain greater than 7{\%} from baseline was higher in the olanzapine group relative to risperidone, but neither active-treatment group showed a statistical difference from placebo (1.1{\%}). No other statistically significant and clinically relevant differences were seen for any other vital sign, electrocardiographic measure, or laboratory hematology and chemistry, including glucose, except for cholesterol, which decreased from baseline to endpoint in both active-treatment groups. Conclusions: Patients' neuropsychiatric functioning improved with olanzapine, risperidone, and placebo treatment. There was a substantial response in the placebo group, and no significant differences emerged among treatments.",
author = "Deberdt, {Walter G.} and Dysken, {Maurice W.} and Rappaport, {Stephen A.} and Feldman, {Peter D.} and Young, {Carrie A.} and Hay, {Donald P.} and Lehman, {Deborah L.} and Martin Dossenbach and Degenhardt, {Elisabeth K.} and Alan Breier",
year = "2005",
doi = "10.1097/00019442-200508000-00012",
language = "English (US)",
volume = "13",
pages = "722--730",
journal = "American Journal of Geriatric Psychiatry",
issn = "1064-7481",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia

AU - Deberdt, Walter G.

AU - Dysken, Maurice W.

AU - Rappaport, Stephen A.

AU - Feldman, Peter D.

AU - Young, Carrie A.

AU - Hay, Donald P.

AU - Lehman, Deborah L.

AU - Dossenbach, Martin

AU - Degenhardt, Elisabeth K.

AU - Breier, Alan

PY - 2005

Y1 - 2005

N2 - Objective: The authors compared efficacy of olanzapine versus placebo and risperidone as measured by the Neuropsychiatric Inventory and Clinical Global Impression-Severity of Psychosis scale in patients with dementia-related psychosis. Methods: Patients with moderate-to-severe psychotic symptoms associated with dementia were recruited from outpatient or residential settings and randomly assigned to 10-week, double-blind, flexible-dose treatment with olanzapine (N = 204; 2.5 mg-10 mg/day; mean: 5.2 mg/ day), risperidone (N = 196; 0.5 mg-2 mg/day; mean: 1.0 mg/day) or placebo (N = 94). Results: Most measures of neuropsychiatric functioning improved in all treatment groups, including the placebo group, and no significant treatment differences occurred. Overall discontinuation was lowest in the placebo group, and the olanzapine group had a significantly higher incidence of discontinuation due to adverse events (16.2%) relative to placebo (3.2%) and risperidone (8.7%) groups. Treatment-emergent extra-pyramidal symptoms were more numerous for risperidone- than placebo- or olanzapine-treated patients. Abnormally high prolactin levels occurred in 78.0% of risperidone patients, compared with 16.7% for olanzapine and 5.0% for placebo. The incidence of weight gain greater than 7% from baseline was higher in the olanzapine group relative to risperidone, but neither active-treatment group showed a statistical difference from placebo (1.1%). No other statistically significant and clinically relevant differences were seen for any other vital sign, electrocardiographic measure, or laboratory hematology and chemistry, including glucose, except for cholesterol, which decreased from baseline to endpoint in both active-treatment groups. Conclusions: Patients' neuropsychiatric functioning improved with olanzapine, risperidone, and placebo treatment. There was a substantial response in the placebo group, and no significant differences emerged among treatments.

AB - Objective: The authors compared efficacy of olanzapine versus placebo and risperidone as measured by the Neuropsychiatric Inventory and Clinical Global Impression-Severity of Psychosis scale in patients with dementia-related psychosis. Methods: Patients with moderate-to-severe psychotic symptoms associated with dementia were recruited from outpatient or residential settings and randomly assigned to 10-week, double-blind, flexible-dose treatment with olanzapine (N = 204; 2.5 mg-10 mg/day; mean: 5.2 mg/ day), risperidone (N = 196; 0.5 mg-2 mg/day; mean: 1.0 mg/day) or placebo (N = 94). Results: Most measures of neuropsychiatric functioning improved in all treatment groups, including the placebo group, and no significant treatment differences occurred. Overall discontinuation was lowest in the placebo group, and the olanzapine group had a significantly higher incidence of discontinuation due to adverse events (16.2%) relative to placebo (3.2%) and risperidone (8.7%) groups. Treatment-emergent extra-pyramidal symptoms were more numerous for risperidone- than placebo- or olanzapine-treated patients. Abnormally high prolactin levels occurred in 78.0% of risperidone patients, compared with 16.7% for olanzapine and 5.0% for placebo. The incidence of weight gain greater than 7% from baseline was higher in the olanzapine group relative to risperidone, but neither active-treatment group showed a statistical difference from placebo (1.1%). No other statistically significant and clinically relevant differences were seen for any other vital sign, electrocardiographic measure, or laboratory hematology and chemistry, including glucose, except for cholesterol, which decreased from baseline to endpoint in both active-treatment groups. Conclusions: Patients' neuropsychiatric functioning improved with olanzapine, risperidone, and placebo treatment. There was a substantial response in the placebo group, and no significant differences emerged among treatments.

UR - http://www.scopus.com/inward/record.url?scp=23944487151&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23944487151&partnerID=8YFLogxK

U2 - 10.1097/00019442-200508000-00012

DO - 10.1097/00019442-200508000-00012

M3 - Article

VL - 13

SP - 722

EP - 730

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

SN - 1064-7481

IS - 8

ER -