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- W1990902416 abstract "Sink KM, Holden KF, Yaffe K. Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA 2005;293:596–608.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q How effective are pharmacological treatments for the neuropsychiatric symptoms of dementia? ### ![Graphic][5] Design:Systematic review.### ![Graphic][6] Data sources:MEDLINE (1966 to July 2004), Cochrane Database of Systematic Reviews, plus hand search of reference lists.### ![Graphic][7] Study selection and analysis:The review included placebo controlled, double blind randomised controlled trials (RCTs) of drug therapy for the neuropsychiatric symptoms of dementia, and meta-analyses of such RCTs. Studies of drugs not available in the US or no longer in clinical use and studies of depressive symptoms alone were excluded.### ![Graphic][8] Outcomes:Neuropsychiatric symptoms.Atypical antipsychotics: six RCTs, all of risperidone or olanzapine, met inclusion criteria. Four RCTs (1380 people) found that antipsychotic treatment improved neuropsychiatric symptoms compared with placebo (see http://www.ebmentalhealth.com/supplemental for table). However, improvements were often small, and risperidone and olanzapine have been reported to increase cerebrovascular events in people with dementia. Typical antipsychotics: two meta-analyses met inclusion criteria. One meta-analysis (seven RCTs; 252 people) found that typical antipsychotics reduced neuropsychiatric symptoms more than placebo (standardised effect size 0.18; p = 0.004). The second meta-analysis (five RCTs; 573 people) found that haloperidol reduced aggression … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DSink%26rft.auinit1%253DK.%2BM.%26rft.volume%253D293%26rft.issue%253D5%26rft.spage%253D596%26rft.epage%253D608%26rft.atitle%253DPharmacological%2BTreatment%2Bof%2BNeuropsychiatric%2BSymptoms%2Bof%2BDementia%253A%2BA%2BReview%2Bof%2Bthe%2BEvidence%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.293.5.596%26rft_id%253Dinfo%253Apmid%252F15687315%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.293.5.596&link_type=DOI [3]: /lookup/external-ref?access_num=15687315&link_type=MED&atom=%2Febmental%2F8%2F3%2F83.atom [4]: /lookup/external-ref?access_num=000226694200023&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif" @default.
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- W1990902416 date "2005-08-01" @default.
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- W1990902416 title "Review: pharmacotherapy provides minimal improvements in the neuropsychiatric symptoms of dementia" @default.
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- W1990902416 doi "https://doi.org/10.1136/ebmh.8.3.83" @default.
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!["Sink KM, Holden KF, Yaffe K. Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA 2005;293:596–608.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q How effective are pharmacological treatments for the neuropsychiatric symptoms of dementia? ### ![Graphic][5] Design:Systematic review.### ![Graphic][6] Data sources:MEDLINE (1966 to July 2004), Cochrane Database of Systematic Reviews, plus hand search of reference lists.### ![Graphic][7] Study selection and analysis:The review included placebo controlled, double blind randomised controlled trials (RCTs) of drug therapy for the neuropsychiatric symptoms of dementia, and meta-analyses of such RCTs. Studies of drugs not available in the US or no longer in clinical use and studies of depressive symptoms alone were excluded.### ![Graphic][8] Outcomes:Neuropsychiatric symptoms.Atypical antipsychotics: six RCTs, all of risperidone or olanzapine, met inclusion criteria. Four RCTs (1380 people) found that antipsychotic treatment improved neuropsychiatric symptoms compared with placebo (see http://www.ebmentalhealth.com/supplemental for table). However, improvements were often small, and risperidone and olanzapine have been reported to increase cerebrovascular events in people with dementia. Typical antipsychotics: two meta-analyses met inclusion criteria. One meta-analysis (seven RCTs; 252 people) found that typical antipsychotics reduced neuropsychiatric symptoms more than placebo (standardised effect size 0.18; p = 0.004). The second meta-analysis (five RCTs; 573 people) found that haloperidol reduced aggression … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DSink%26rft.auinit1%253DK.%2BM.%26rft.volume%253D293%26rft.issue%253D5%26rft.spage%253D596%26rft.epage%253D608%26rft.atitle%253DPharmacological%2BTreatment%2Bof%2BNeuropsychiatric%2BSymptoms%2Bof%2BDementia%253A%2BA%2BReview%2Bof%2Bthe%2BEvidence%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.293.5.596%26rft_id%253Dinfo%253Apmid%252F15687315%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.293.5.596&link_type=DOI [3]: /lookup/external-ref?access_num=15687315&link_type=MED&atom=%2Febmental%2F8%2F3%2F83.atom [4]: /lookup/external-ref?access_num=000226694200023&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif"](?object=%22Sink%20KM%2C%20Holden%20KF%2C%20Yaffe%20K.%20Pharmacological%20treatment%20of%20neuropsychiatric%20symptoms%20of%20dementia%3A%20a%20review%20of%20the%20evidence.%20JAMA%202005%3B293%3A596%E2%80%93608.%5BOpenUrl%5D%5B1%5D%5BCrossRef%5D%5B2%5D%5BPubMed%5D%5B3%5D%5BWeb%20of%20Science%5D%5B4%5D%E2%80%A8%20Q%20How%20effective%20are%20pharmacological%20treatments%20for%20the%20neuropsychiatric%20symptoms%20of%20dementia%3F%20%23%23%23%20!%5BGraphic%5D%5B5%5D%20Design%3ASystematic%20review.%23%23%23%20!%5BGraphic%5D%5B6%5D%20Data%20sources%3AMEDLINE%20(1966%20to%20July%202004)%2C%20Cochrane%20Database%20of%20Systematic%20Reviews%2C%20plus%20hand%20search%20of%20reference%20lists.%23%23%23%20!%5BGraphic%5D%5B7%5D%20Study%20selection%20and%20analysis%3AThe%20review%20included%20placebo%20controlled%2C%20double%20blind%20randomised%20controlled%20trials%20(RCTs)%20of%20drug%20therapy%20for%20the%20neuropsychiatric%20symptoms%20of%20dementia%2C%20and%20meta-analyses%20of%20such%20RCTs.%20Studies%20of%20drugs%20not%20available%20in%20the%20US%20or%20no%20longer%20in%20clinical%20use%20and%20studies%20of%20depressive%20symptoms%20alone%20were%20excluded.%23%23%23%20!%5BGraphic%5D%5B8%5D%20Outcomes%3ANeuropsychiatric%20symptoms.Atypical%20antipsychotics%3A%20six%20RCTs%2C%20all%20of%20risperidone%20or%20olanzapine%2C%20met%20inclusion%20criteria.%20Four%20RCTs%20(1380%20people)%20found%20that%20antipsychotic%20treatment%20improved%20neuropsychiatric%20symptoms%20compared%20with%20placebo%20(see%20http%3A%2F%2Fwww.ebmentalhealth.com%2Fsupplemental%20for%20table).%20However%2C%20improvements%20were%20often%20small%2C%20and%20risperidone%20and%20olanzapine%20have%20been%20reported%20to%20increase%20cerebrovascular%20events%20in%20people%20with%20dementia.%20Typical%20antipsychotics%3A%20two%20meta-analyses%20met%20inclusion%20criteria.%20One%20meta-analysis%20(seven%20RCTs%3B%20252%20people)%20found%20that%20typical%20antipsychotics%20reduced%20neuropsychiatric%20symptoms%20more%20than%20placebo%20(standardised%20effect%20size%200.18%3B%20p%E2%80%8A%3D%E2%80%8A0.004).%20The%20second%20meta-analysis%20(five%20RCTs%3B%20573%20people)%20found%20that%20haloperidol%20reduced%20aggression%20%E2%80%A6%20%5B1%5D%3A%20%7Bopenurl%7D%3Fquery%3Drft.jtitle%25253DJAMA%2526rft.stitle%25253DJAMA%2526rft.issn%25253D0002-9955%2526rft.aulast%25253DSink%2526rft.auinit1%25253DK.%252BM.%2526rft.volume%25253D293%2526rft.issue%25253D5%2526rft.spage%25253D596%2526rft.epage%25253D608%2526rft.atitle%25253DPharmacological%252BTreatment%252Bof%252BNeuropsychiatric%252BSymptoms%252Bof%252BDementia%25253A%252BA%252BReview%252Bof%252Bthe%252BEvidence%2526rft_id%25253Dinfo%25253Adoi%25252F10.1001%25252Fjama.293.5.596%2526rft_id%25253Dinfo%25253Apmid%25252F15687315%2526rft.genre%25253Darticle%2526rft_val_fmt%25253Dinfo%25253Aofi%25252Ffmt%25253Akev%25253Amtx%25253Ajournal%2526ctx_ver%25253DZ39.88-2004%2526url_ver%25253DZ39.88-2004%2526url_ctx_fmt%25253Dinfo%25253Aofi%25252Ffmt%25253Akev%25253Amtx%25253Actx%20%5B2%5D%3A%20%2Flookup%2Fexternal-ref%3Faccess_num%3D10.1001%2Fjama.293.5.596%26link_type%3DDOI%20%5B3%5D%3A%20%2Flookup%2Fexternal-ref%3Faccess_num%3D15687315%26link_type%3DMED%26atom%3D%252Febmental%252F8%252F3%252F83.atom%20%5B4%5D%3A%20%2Flookup%2Fexternal-ref%3Faccess_num%3D000226694200023%26link_type%3DISI%20%5B5%5D%3A%20%2Fembed%2Finline-graphic-1.gif%20%5B6%5D%3A%20%2Fembed%2Finline-graphic-2.gif%20%5B7%5D%3A%20%2Fembed%2Finline-graphic-3.gif%20%5B8%5D%3A%20%2Fembed%2Finline-graphic-4.gif%22){kind=link}