Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Int Psychogeriatr. 2011 Nov;23(9):1515-9. doi: 10.1017/S1041610211000743. Epub 2011 Apr 15.
Antipsychotics are frequently used to treat psychosis, aggression and agitation in patients with Alzheimer's disease (AD), but safety warnings abound. Escitalopram was investigated since citalopram has demonstrated some effectiveness in AD. We compared escitalopram and risperidone for psychotic symptoms and agitation associated with AD.
Inpatients with AD, who had been hospitalized because of behavioral symptoms, were recruited to a six-week randomized, double-blind, controlled trial. Participants (n = 40) were randomized to once daily risperidone 1 mg or escitalopram 10 mg.
The NPI total score improved in both groups. Onset was earlier in the risperidone-treated group, but improvement did not significantly differ between groups by study end. Completion rates differed for escitalopram (75%) and risperidone (55%), mainly due to adverse events. There were no adverse events in the escitalopram group, while in the risperidone group two patients suffered severe extrapyramidal symptoms and four patients suffered acute physical illness necessitating transfer to general hospital.
Escitalopram and risperidone did not differ in efficacy in reducing psychotic symptoms and agitation in patients with AD. Completion rates were higher for escitalopram-treated patients. Replication in larger trials with ambulatory patients is needed.
抗精神病药常用于治疗阿尔茨海默病（AD）患者的精神病、攻击和激越症状，但安全警告层出不穷。西酞普兰已被研究，因为西酞普兰已显示出对 AD 的一些疗效。我们比较了西酞普兰和利培酮治疗 AD 相关的精神病症状和激越。
因行为症状住院的 AD 住院患者被招募参加一项为期 6 周的随机、双盲、对照试验。参与者（n = 40）随机分为每天一次利培酮 1mg 或西酞普兰 10mg。
两组的 NPI 总分均有所改善。利培酮治疗组的起效时间更早，但研究结束时两组的改善情况无显著差异。西酞普兰（75%）和利培酮（55%）的完成率不同，主要是由于不良事件。西酞普兰组无不良事件，而利培酮组有 2 例出现严重的锥体外系症状，4 例出现急性躯体疾病，需要转入综合医院。
西酞普兰和利培酮在减轻 AD 患者精神病症状和激越方面的疗效无差异。西酞普兰组的完成率更高。需要在更大规模的、有活动能力的患者的试验中进行复制。
