Olanzapine versus placebo in the treatment of psychosis with or without associated behavioral disturbances in patients with Alzheimer's disease

Peter Paul De Deyn, Manuel Martín Carrasco, Walter Deberdt, Claude Jeandel, Donald P. Hay, Peter D. Feldman, Carrie A. Young, Deborah L. Lehman, Alan Breier

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Objectives: Psychotic symptoms and behavioral disturbances are a concern in the care of elderly patients with Alzheimer's dementia (AD). This study was conducted to compare the efficacy of olanzapine versus placebo in patients with psychotic symptoms associated with AD in long-term or continuing-care settings. Methods: Patients (n = 652) with AD and delusions or hallucinations were randomly assigned to 10 weeks of double-blind treatment with placebo or fixed-dose olanzapine (1.0, 2.5, 5.0, 7.5 mg/day). Results: Mean age was 76.6 ± 10.4 years. Repeated-measures analysis showed significant improvement from baseline in NPI/NH Psychosis Total scores (sum of Delusions, Hallucinations items-primary efficacy measure) in all five treatment groups (p <0.001), but no pairwise treatment differences were seen at the 10-week endpoint. However, under LOCF analysis, improvement in the 7.5 mg olanzapine group (-6.2 ± 4.9) was significantly greater than with placebo (-5.0 ± 6.1, p = 0.008), while endpoint CGI-C scores showed the greatest improvement in the Olz 2.5 olanzapine group (2.8 ± 1.4, p = 0.030) relative to placebo (3.2 ± 1.4). There were significant overall treatment-group differences in increased weight, anorexia, and urinary incontinence, with olanzapine showing numerically higher incidences. However, neither the incidence of any other individual events, including extrapyramidal symptoms, nor of total adverse events occurred with significantly higher frequency in any olanzapine group relative to placebo. No clinically relevant significant changes were seen across groups in cognition or any other vital sign or laboratory measure, including glucose, triglyceride, and cholesterol. Conclusions: While 1.0 mg olanzapine did not show significant differences from placebo, the 2.5 mg dose was a reasonable starting dose. Olanzapine at 7.5 mg/day significantly decreased psychosis and overall behavioral disturbances (NPI/NH, BPRS) and was well tolerated.

Original languageEnglish (US)
Pages (from-to)115-126
Number of pages12
JournalInternational Journal of Geriatric Psychiatry
Volume19
Issue number2
DOIs
StatePublished - Feb 2004

Fingerprint

olanzapine
Psychotic Disorders
Alzheimer Disease
Placebos
Delusions
Hallucinations
Therapeutics
Behavioral Symptoms
Vital Signs
Incidence
Urinary Incontinence
Anorexia
Cognition

Keywords

  • Alzheimer disease
  • Atypical antipsychotic
  • Dementia
  • Olanzapine
  • Psychosis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Olanzapine versus placebo in the treatment of psychosis with or without associated behavioral disturbances in patients with Alzheimer's disease. / De Deyn, Peter Paul; Carrasco, Manuel Martín; Deberdt, Walter; Jeandel, Claude; Hay, Donald P.; Feldman, Peter D.; Young, Carrie A.; Lehman, Deborah L.; Breier, Alan.

In: International Journal of Geriatric Psychiatry, Vol. 19, No. 2, 02.2004, p. 115-126.

Research output: Contribution to journalArticle

De Deyn, Peter Paul ; Carrasco, Manuel Martín ; Deberdt, Walter ; Jeandel, Claude ; Hay, Donald P. ; Feldman, Peter D. ; Young, Carrie A. ; Lehman, Deborah L. ; Breier, Alan. / Olanzapine versus placebo in the treatment of psychosis with or without associated behavioral disturbances in patients with Alzheimer's disease. In: International Journal of Geriatric Psychiatry. 2004 ; Vol. 19, No. 2. pp. 115-126.
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