Risperidone Versus Yokukansan in the Treatment of Severe Alzheimer’s Disease

Kouichi Shin,Yuko Furuhashi

doi:10.4236/ijcm.2011.22028

Kouichi Shin, Yuko Furuhashi

Open Access

https://doi.org/10.4236/ijcm.2011.22028

Copy DOI

Abstract

PURPOSE: Patients with AD commonly exhibit behavioral and psychological symptoms of dementia (BPSD). This study is aimed to compare the efficacy of yokukansan (YKS) and risperidone (RIS) on BPSD in patients with severe Alzheimer’s disease (AD). METHODS: Thirty eight inpatients with AD were investigated. Patients were randomly as-signed to the YKS group (N = 18) or the RIS group (N = 20) and treated for 4 weeks. The primary outcomes were changes in the scores on the Neuropsychiatric Inventory (NPI), the Mini-Mental State Examination (MMSE), the Bar-thel Index, and the Cohen-Mansfield Agitation Inventory (CMAI). The frequency of extrapyramidal symptoms (EPS) and other adverse events were recorded at every visit. RESULTS: All participants in both groups completed the trial. The Barthel Index did not significantly change either in the RIS group or the YKS group. The MMSE scores did not change either in the RIS group or the YKS group. Significant improvements in mean total NPI and CMAI scores showed in both groups. Between the YKS and the RIS groups, there were no significant differences in the NPI or the CMAI scores. EPS and other serious adverse effects were not observed in either group. CONCLUSIONS: In this 4-week trial, YKS treatment significantly improved BPSD in the patients with severe AD. The present study suggests that YKS is as effective as RIS on BPSD with severe AD.

Highlights

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that presents with deterioration of memory and cognitive function, progressive impairment of daily activities, and many neuropsychiatric impairments [1]
Between the YKS and the RIS groups, there were no significant differences in the Neuropsychiatric Inventory (NPI) or the Cohen-Mansfield Agitation Inventory (CMAI) scores
The present study suggests that YKS is as effective as RIS on behavioral and psychological symptoms of dementia (BPSD) with severe AD

Summary

Introduction

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that presents with deterioration of memory and cognitive function, progressive impairment of daily activities, and many neuropsychiatric impairments [1]. Patients with AD commonly exhibit behavioral and psychological symptoms of dementia (BPSD). When BPSD are moderate to severe, an appropriate pharmacological treatment is needed. While there have been several studies of pharmacological interventions for BPSD, a single strategy for treatment of BPSD has not been sufficiently supported [2,3,4]. The utility of risperidone in patients with BPSD has been evaluated in two placebo-controlled, double-blind clinical trials [5,6]. The study of long-term trials reported that low-dose risperidone was effective and well tolerated in the treatment of BPSD [7]. Quetiapine did not significantly improve psychosis scores despite good compliance and a reasonable time to attain treatment [8]

Objectives

Findings

Methods

Conclusion