Thursday, 21 August 2003
This presentation is part of : What Works in a Clinical Approach to Dementia: Stages and Cultures

S090-004 Intermediate Stage: Psychiatric Symptoms and Caregiver Burden

Angel Moriņigo, Psychiatry, Psychiatry, Valme University Hospital, Sevilla, Spain

Objective: Behavioral and Psychological symptoms are very prevalent in Dementia, and most disruptive for patients and caregivers (IPA; BPSD, 1998 and 200). Pharmacological treatment in intermediate stages of Dementia is a common approach to treat BPSD. To identify specific "symptomatic clusters" for more accurate treatments is essential (Lawlor, 2001)

Design: A 3-year retrospective sample of demented patients with BPSD, treated with atypical neuroleptics, among other psychotropic agents, is presented.

Materials and Methods: 83 patientes received pharmacological treatment for their BPSD; 62 were treated with an atypical neuroleptic (37 with Olanzapine, 22 with Risperidone and 3 with Quetiapine), the rest (21) had other psychoparmacological treatments. BPSD were rated with the Neuropsychiatric Inventory (Cummings, 1994) and the Cognitive Deficit was evaluated with the MiniMental State MMS (Folstein, 1975). An analysis of efficacy among the different approaches will be presented.

Results: Patients reduced BPSD by more than a 50% after the first month of treatment. No differences were found among different drugs in efficacy. When associated with Cholinesterase inhibitors Olanzapine showed excellent results for treating this conditions.

Conclusion: Atypical Neuroleptics are an excellent treatment for BPSD. Olanzapine is an efficacious drug , with an excellent safety profile (no anticholinergic effects were described) for treating these symptoms. Risperidone had the same efficacity, and Quetiapine was reserved to treat patients with previous extrapiramidal symptoms (Parkinson and Lewy Body Dementias).

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