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A Pilot Study of Haloperidol Treatment of Psychosis and Behavioral Disturbance in Alzheimer's Disease

A Pilot Study of Haloperidol Treatment of Psychosis and Behavioral Disturbance in Alzheimer's... Abstract • Nine outpatients meeting research criteria for probable Alzheimer's disease who had psychosis or behavioral disturbance participated in a single-blind, placebo-controlled pilot study. Oral haloperidol in doses of 1 to 5 mg daily improved target symptoms, confirmed by doubleblind ratings of videotaped interviews. Patients could not be maintained on more than 4 mg of haloperidol daily due to the severity of extrapyramidal side effects. Modified Mini-Mental State scores worsened while taking haloperidol, with only partial recovery in the final 4-week placebo phase. Severe extrapyramidal side effects and decline in cognitive function may compromise the efficacy of commonly used doses of neuroleptic drugs in patients with Alzheimer's disease. References 1. Risse SC, Barnes R. Pharmacologic treatment of agitation associated with dementia . J Am Geriatr Soc . 1986;34:368-376. 2. Raskind MA, Risse SC, Lampe TH. Dementia and antipsychotic drugs . J Clin Psychiatry . 1987;48( (5 suppl) ):16-18. 3. Gilleard CJ, Morgan K, Wade BE. Patterns of neuroleptic use among the institutionalized elderly . Acta Psychiatr Scand . 1983;68:419-425.Crossref 4. Prien Y, Haber PA, Caffey EM Jr. The use of psychoactive drugs in elderly patients with psychiatric disorders: survey conducted in twelve Veterans Administration hospitals . J Am Geriatr Soc . 1975;23:104-112. 5. Michel K, Kolakowska T. A survey of prescribing psychotropic drugs in two psychiatric hospitals . Br J Psychiatry . 1981;138:217-221.Crossref 6. Helms PM. Efficacy of antipsychotics in the treatment of the behavioral complications of dementia . J Am Geriatr Soc . 1985;33:206-209. 7. Devanand DP, Sackeim HA, Mayeux R. Psychosis, behavioral disturbance, and the use of neuroleptics in dementia . Compr Psychiatry . 1988;29:387-401.Crossref 8. McKhann G, Drachman D, Folstein MF, et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group . Neurology . 1984;34:939-944.Crossref 9. Wocjik JD, Gelenburg AJ, La Brie RA, et al. Prevalence of tardive dyskinesia in an outpatient population . Compr Psychiatry . 1980;21:370-380.Crossref 10. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile changes in the cerebral gray matter of elderly subjects . Br J Psychiatry . 1968;114:797-811.Crossref 11. Folstein MF, Folstein SE, McHugh PR. 'Mini-mental state': a practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res . 1975;12:189-198.Crossref 12. Stern Y, Sano M, Paulson J, Mayeux R. Modified mini-mental state examination: validity and reliability . Neurology . 1987;37( (suppl I) ):179-186.Crossref 13. Shrout PE, Fliess JH. Intraclass correlations: uses in assessing rater reliability . Psychol Bull . 1979;86:420-428.Crossref 14. Spohn HE, Lacoursiere RB, Thompson K, et al. Phenothiazine effects on psychological and physiological dysfunction in chronic schizophrenics . Arch Gen Psychiatry . 1977;34:633-644.Crossref 15. DiMascio A, Havens LL, Klerman GL. The psychopharmacology of phenothiazine compounds: a comparative study of the effects of chloropromazine, promethazine, trifluoperazine and perphenazine in normal males . J Nerv Ment Dis . 1963;136:15-28, 168-186.Crossref 16. Davies P, Maloney AJF. Selective loss of central cholinergic neurons in Alzheimer's disease . Lancet . 1976;2:1403.Crossref 17. Steele C, Lucas MJ, Tune L. Haloperidol versus thioridazine in the treatment of behavioral symptoms in senile dementia of the Alzheimer's type: preliminary findings . J Clin Psychiatry . 1986;47:310-312. 18. Gottlieb GL, McAllister TW, Gur RC. Depot neuroleptics in the treatment of behavioral disorders in patients with Alzheimer's disease . J Am Geriatr Soc . 1988;36:642-644. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

A Pilot Study of Haloperidol Treatment of Psychosis and Behavioral Disturbance in Alzheimer's Disease

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520440036018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Nine outpatients meeting research criteria for probable Alzheimer's disease who had psychosis or behavioral disturbance participated in a single-blind, placebo-controlled pilot study. Oral haloperidol in doses of 1 to 5 mg daily improved target symptoms, confirmed by doubleblind ratings of videotaped interviews. Patients could not be maintained on more than 4 mg of haloperidol daily due to the severity of extrapyramidal side effects. Modified Mini-Mental State scores worsened while taking haloperidol, with only partial recovery in the final 4-week placebo phase. Severe extrapyramidal side effects and decline in cognitive function may compromise the efficacy of commonly used doses of neuroleptic drugs in patients with Alzheimer's disease. References 1. Risse SC, Barnes R. Pharmacologic treatment of agitation associated with dementia . J Am Geriatr Soc . 1986;34:368-376. 2. Raskind MA, Risse SC, Lampe TH. Dementia and antipsychotic drugs . J Clin Psychiatry . 1987;48( (5 suppl) ):16-18. 3. Gilleard CJ, Morgan K, Wade BE. Patterns of neuroleptic use among the institutionalized elderly . Acta Psychiatr Scand . 1983;68:419-425.Crossref 4. Prien Y, Haber PA, Caffey EM Jr. The use of psychoactive drugs in elderly patients with psychiatric disorders: survey conducted in twelve Veterans Administration hospitals . J Am Geriatr Soc . 1975;23:104-112. 5. Michel K, Kolakowska T. A survey of prescribing psychotropic drugs in two psychiatric hospitals . Br J Psychiatry . 1981;138:217-221.Crossref 6. Helms PM. Efficacy of antipsychotics in the treatment of the behavioral complications of dementia . J Am Geriatr Soc . 1985;33:206-209. 7. Devanand DP, Sackeim HA, Mayeux R. Psychosis, behavioral disturbance, and the use of neuroleptics in dementia . Compr Psychiatry . 1988;29:387-401.Crossref 8. McKhann G, Drachman D, Folstein MF, et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group . Neurology . 1984;34:939-944.Crossref 9. Wocjik JD, Gelenburg AJ, La Brie RA, et al. Prevalence of tardive dyskinesia in an outpatient population . Compr Psychiatry . 1980;21:370-380.Crossref 10. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile changes in the cerebral gray matter of elderly subjects . Br J Psychiatry . 1968;114:797-811.Crossref 11. Folstein MF, Folstein SE, McHugh PR. 'Mini-mental state': a practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res . 1975;12:189-198.Crossref 12. Stern Y, Sano M, Paulson J, Mayeux R. Modified mini-mental state examination: validity and reliability . Neurology . 1987;37( (suppl I) ):179-186.Crossref 13. Shrout PE, Fliess JH. Intraclass correlations: uses in assessing rater reliability . Psychol Bull . 1979;86:420-428.Crossref 14. Spohn HE, Lacoursiere RB, Thompson K, et al. Phenothiazine effects on psychological and physiological dysfunction in chronic schizophrenics . Arch Gen Psychiatry . 1977;34:633-644.Crossref 15. DiMascio A, Havens LL, Klerman GL. The psychopharmacology of phenothiazine compounds: a comparative study of the effects of chloropromazine, promethazine, trifluoperazine and perphenazine in normal males . J Nerv Ment Dis . 1963;136:15-28, 168-186.Crossref 16. Davies P, Maloney AJF. Selective loss of central cholinergic neurons in Alzheimer's disease . Lancet . 1976;2:1403.Crossref 17. Steele C, Lucas MJ, Tune L. Haloperidol versus thioridazine in the treatment of behavioral symptoms in senile dementia of the Alzheimer's type: preliminary findings . J Clin Psychiatry . 1986;47:310-312. 18. Gottlieb GL, McAllister TW, Gur RC. Depot neuroleptics in the treatment of behavioral disorders in patients with Alzheimer's disease . J Am Geriatr Soc . 1988;36:642-644.

Journal

Archives of NeurologyAmerican Medical Association

Published: Aug 1, 1989

References