Treatment of delusions in Alzheimer's disease--response to pharmacotherapy

Dement Geriatr Cogn Disord. 2006;22(3):260-6. doi: 10.1159/000094975. Epub 2006 Aug 10.

Abstract

Delusions are commonly encountered symptoms in patients with Alzheimer's disease and may lead to significant morbidity. The purpose of this article is to review all clinical trials to date focusing on the management of delusions in patients with Alzheimer's disease to determine the level of evidence for treatment. To achieve this objective, Medline was searched using the key words delusions, dementia, Alzheimer's disease and psychosis. Three main categories of treatment were identified: atypical antipsychotics, cholinesterase inhibitors, and other miscellaneous treatments. It was concluded that all forms of treatment were effective although the greatest burden of evidence existed for risperidone and donepezil. Side effects were noted in all forms of treatment and included somnolence and extrapyramidal effects for antipsychotic medications, whereas gastrointestinal effects were more prevalent in studies involving cholinesterase inhibitors. Further large scale, double-blind, randomized, controlled studies are required before a definitive conclusion can be reached. To our knowledge this is the only systematic review of this area.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications*
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / psychology
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Cholinesterase Inhibitors / adverse effects
  • Cholinesterase Inhibitors / therapeutic use
  • Delusions / drug therapy*
  • Delusions / etiology*
  • Delusions / psychology
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Nootropic Agents / adverse effects
  • Nootropic Agents / therapeutic use*
  • Randomized Controlled Trials as Topic

Substances

  • Antipsychotic Agents
  • Cholinesterase Inhibitors
  • Nootropic Agents