Aripiprazole for the treatment of psychosis in patients with Alzheimer's disease

A randomized, placebo-controlled study

Peter De Deyn, Dilip V. Jeste, Rene Swanink, Dusan Kostic, Christopher Breder

Research output: Contribution to journalArticle

Abstract

This study compared the efficacy, safety, and tolerability of aripiprazole, a novel antipsychotic, with placebo in patients with psychosis associated with Alzheimer's Disease (AD). This 10-week, double-blind, multicenter study randomized 208 outpatients (mean age, 81.5 years) with AD-associated psychosis to aripiprazole (n = 106) or placebo (n = 102). The initial aripiprazole dose of 2 mg/d was titrated upwards (5, 10, or 15 mg/d) according to efficacy and tolerability. Evaluations included Neuropsychiatric Inventory (NPI) Psychosis subscale and Brief Psychiatric Rating Scale (BPRS), adverse event (AE) reports, extrapyramidal symptoms (EPS) rating scales, and body weight. Overall, 172 patients (83%) completed the study. Mean aripiprazole dose at end point was 10.0 mg/d. The NPI Psychosis subscale score showed improvements in both groups (aripiprazole, -6.55; placebo, -5.52; P = 0.17 at end point). Aripiprazole-treated patients showed significantly greater improvements from baseline in BPRS Psychosis and BPRS Core subscale scores at end point compared with placebo. AEs were generally mild to moderate in severity and included (aripiprazole vs. placebo): urinary tract infection (8% vs. 12%), accidental injury (8% vs. 5%), somnolence (8% vs. 1%), and bronchitis (6% vs. 3%). Somnolence was mild and not associated with falls or accidental injury. There were no significant differences from placebo in EPS scores, or clinically significant ECG abnormalities, vital signs, or weight. In conclusion, aripiprazole showed similar improvements to placebo in psychotic symptoms as assessed by NPI Psychosis subscale scores, but significantly greater effects on BPRS Core and Psychosis assessments in community-living AD patients with psychosis. Aripiprazole was safe and well tolerated in this patient population.

Original languageEnglish (US)
Pages (from-to)463-467
Number of pages5
JournalJournal of Clinical Psychopharmacology
Volume25
Issue number5
DOIs
StatePublished - Oct 2005
Externally publishedYes

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Psychotic Disorders
Alzheimer Disease
Placebos
Brief Psychiatric Rating Scale
Therapeutics
Equipment and Supplies
Accidental Falls
Aripiprazole
Vital Signs
Bronchitis
Wounds and Injuries
Double-Blind Method
Urinary Tract Infections
Antipsychotic Agents
Multicenter Studies
Electrocardiography
Outpatients
Body Weight
Safety
Weights and Measures

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Aripiprazole for the treatment of psychosis in patients with Alzheimer's disease : A randomized, placebo-controlled study. / De Deyn, Peter; Jeste, Dilip V.; Swanink, Rene; Kostic, Dusan; Breder, Christopher.

In: Journal of Clinical Psychopharmacology, Vol. 25, No. 5, 10.2005, p. 463-467.

Research output: Contribution to journalArticle

De Deyn, Peter ; Jeste, Dilip V. ; Swanink, Rene ; Kostic, Dusan ; Breder, Christopher. / Aripiprazole for the treatment of psychosis in patients with Alzheimer's disease : A randomized, placebo-controlled study. In: Journal of Clinical Psychopharmacology. 2005 ; Vol. 25, No. 5. pp. 463-467.
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abstract = "This study compared the efficacy, safety, and tolerability of aripiprazole, a novel antipsychotic, with placebo in patients with psychosis associated with Alzheimer's Disease (AD). This 10-week, double-blind, multicenter study randomized 208 outpatients (mean age, 81.5 years) with AD-associated psychosis to aripiprazole (n = 106) or placebo (n = 102). The initial aripiprazole dose of 2 mg/d was titrated upwards (5, 10, or 15 mg/d) according to efficacy and tolerability. Evaluations included Neuropsychiatric Inventory (NPI) Psychosis subscale and Brief Psychiatric Rating Scale (BPRS), adverse event (AE) reports, extrapyramidal symptoms (EPS) rating scales, and body weight. Overall, 172 patients (83{\%}) completed the study. Mean aripiprazole dose at end point was 10.0 mg/d. The NPI Psychosis subscale score showed improvements in both groups (aripiprazole, -6.55; placebo, -5.52; P = 0.17 at end point). Aripiprazole-treated patients showed significantly greater improvements from baseline in BPRS Psychosis and BPRS Core subscale scores at end point compared with placebo. AEs were generally mild to moderate in severity and included (aripiprazole vs. placebo): urinary tract infection (8{\%} vs. 12{\%}), accidental injury (8{\%} vs. 5{\%}), somnolence (8{\%} vs. 1{\%}), and bronchitis (6{\%} vs. 3{\%}). Somnolence was mild and not associated with falls or accidental injury. There were no significant differences from placebo in EPS scores, or clinically significant ECG abnormalities, vital signs, or weight. In conclusion, aripiprazole showed similar improvements to placebo in psychotic symptoms as assessed by NPI Psychosis subscale scores, but significantly greater effects on BPRS Core and Psychosis assessments in community-living AD patients with psychosis. Aripiprazole was safe and well tolerated in this patient population.",
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