Long-term efficacy of olanzapine in the control of psychotic and behavioral symptoms in nursing home patients with Alzheimer's dementia

Jamie S. Street, W. Scott Clark, Deborah L. Kadam, Steven J. Mitan, Beth E. Juliar, Peter D. Feldman, Alan Breier

Research output: Contribution to journalArticle

83 Scopus citations

Abstract

Background: Psychotic symptoms and behavioral disturbances are a leading cause of institutionalization in elderly patients with Alzheimer's disease (AD). Objectives: Elderly nursing home patients (n = 105) with possible or probable AD were entered into a multicenter study to determine the long-term efficacy and safety of olanzapine in treatment of psychotic symptoms and behavioral disturbances due to AD. Methods: Following a double-blind, 6-week exposure to fixed-dose olanzapine (5, 10, or 15 mg/d), patients entered an additional 18-week, open-label, flexible-dose treatment. Baseline was defined from the start of the extension phase. Results: Patients improved significantly on the primary efficacy measure, defined a priori, which consisted of the sum of the Agitation/Aggression, Delusions, and Hallucinations items ('Core') of the NPI/NH. Olanzapine also significantly improved scores for the NPI/NH total and the Core item-associated Occupational Disruptiveness of the NPI/NH, as well as the BPRS total and CGI Severity-of-Alzheimer's scores. Barnes Akathasia scores improved significantly from baseline, while Simpson-Angus and AIMS scores were not significantly changed. Treatment-emergent symptoms included somnolence, accidental injury, and rash. No significant changes were seen in ECGs, including QTc interval, nor in weight or vital signs, including orthostasis. Conclusions: Low-dose olanzapine appears to be effective and well tolerated for treatment of behavioral disturbances and psychotic symptoms due to AD in elderly patients.

Original languageEnglish (US)
Pages (from-to)S62-S70
JournalInternational Journal of Geriatric Psychiatry
Volume16
Issue numberSUPPL. 1
StatePublished - Dec 1 2001

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Keywords

  • Alzheimer's disease
  • Dementia
  • Elderly
  • Neuropsychiatric Inventory
  • Nursing home
  • Olanzapine
  • Psychosis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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