A Double-Blind Comparison of Olanzapine Versus Risperidone in the Acute Treatment of Dementia- Related Behavioral Disturbances in Extended Care Facilities
J Clin Psychiatry 2003;64(6):726-730
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: In addition to demonstrating their
superiority to placebo, there is a need to compare the relative
efficacy and side effects of atypical neuroleptics for the acute
treatment of dementia-related behavioral disturbances in
residents of long-term care facilities.
Method: In a double-blind parallel study
allowing dose titration over 14 days, 39 agitated persons with
DSM-IV dementia who were residing in long-term care facilities
were administered olanzapine (N = 20) or risperidone (N = 19) as
acute treatment. Drug was administered once a day at bedtime. The
initial dosages were olanzapine, 2.5 mg/day, and risperidone, 0.5
mg/day. Titration was allowed to maximum doses of olanzapine, 10
mg/day, and risperidone, 2.0 mg/day. The primary outcome measures
were the Clinical Global Impressions scale (CGI) and the
Neuropsychiatric Inventory (NPI). Data were gathered from 2000 to
Results: Both drugs produced significant
reductions in CGI and NPI scores (p < .0001), but there was no
significant difference between drugs. The mean olanzapine dose
was 6.65 mg/day; for risperidone, the dose was 1.47 mg/day. The
positive drug effect was not accompanied by decreased mobility,
and there was improvement on a quality-of-life measure. The chief
adverse events were drowsiness and falls. At baseline, 42%
(16/38) of subjects in both groups had extrapyramidal symptoms
that increased slightly, but not significantly, by the end of the
Conclusion: Low-dose, once-a-day olanzapine and
risperidone appear to be equally safe and equally effective in
the treatment of dementia-related behavioral disturbances in
residents of extended care facilities.