Published: 20-09-2013 00:00 | Updated: 29-10-2014 10:38

Antipsychotic drug for dementia can be replaced

A new study from Karolinska Institutet shows that it is possible to replace antipsychotic drugs for drugs with fewer side effects when treating neuropsychiatric symptoms in dementia. The researchers suggest that these patients could be treated with so called cholinesterase inhibitors, commonly used to prevent memory loss, provided that they are not aggressive.

Nine out of ten patients with dementia also suffers from behavioral and neuropsychiatric symptoms (NPSD), which includes difficulties to sleep, anxiety, apathy and agitation. These symptoms need to be treated, however most drugs currently used for NPSD have severe side effects. In a clinical, randomized study in patients with dementia (both Alzheimer's disease and other types of dementia) researchers from the Department of Neurobiology, Care Sciences and Society at Karolinska Institutet show that instead of treating the NPSD patients with antipsychotic drugs, it is often possible to get the same result by prescribing cholinesterase inhibitors, provided that the patients do not show any symptoms of agitation or irritation. In this way patients can be treated with less severe side effects from their medication.

In all, 100 adult patients with assumed dementia and NPSD participated in the study, which lasted for 12 weeks. The study is being published in the American Journal of Geriatric.

"NPSD affects all patients on the journey of dementia and requires medication. It is not only the patients who suffer but relatives too, increasing the risk of depression. These patients are also an economic burden to society, and are in many cases hospitalized unnecessarily and taken in to psychiatric custody by force", says first study author Yvonne Freund-Levi, PhD, senior consultant.


Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia: an open randomized trial.
Freund-Levi Y, Jedenius E, Tysen-Bäckström A, Lärksäter M, Wahlund L, Eriksdotter M
Am J Geriatr Psychiatry 2014 Apr;22(4):341-8