Abstract
Aripiprazole is the newest dopamine-D2-receptor partial agonist. The aim of the present study was to determine the efficacy, side-effects, and tolerability of aripiprazole for treating behavioural psychological symptoms of dementia (BPSD).
This study was a 12 week, prospective, structured clinical trial of aripiprazole for the treatment of BPSD. Ten consecutive patients (mean age, 76.8±6.29 years) with BPSD (including those with no history of psychotropic drug use within 4 weeks prior to the study) were enrolled. These patients met the International Classification of Diseases 10th revision (ICD-10) criteria for dementia due to Alzheimer's disease (F00.1, n = 7), vascular dementia (F01.1, n = 2), and Pick's disease (F02.0, n = 1).
The degree of cognitive function, activities of daily living score and the degree of BPSD were determined using the Mini Mental State Examination (MMSE), Disability Assessment for Dementia (DAD) [1], Neuropsychiatric Inventory (NPI), Rating Scale for Aggressive Behaviour in the Elderly (RAGE) [2], and Clinical Global Impression (CGI). The severity of extrapyramidal symptoms was assessed using the Drug-Induced Extrapyramidal Symptoms scale (DIEEPS) [3].
Patients were evaluated at the baseline, and during weeks 2, 4, 6, 8, and 12. The dose of aripiprazole started at 3 mg, and was increased by 3 mg every 2 weeks if needed.
Analyses were performed using the last observation carried forward (LOCF) for patients who withdrew from the study before week 12. The Wilcoxon signed ranks test was used to analyse statistical differences between all scores. p < 0.05 was considered significant. After completely explaining the study to the patients and caregivers, written informed consent was obtained.
Six patients completed the clinical trial, one was discharged, and three withdrew from the study due to side-effects (appetite loss, n = 1; sedation, n = 1; disinhibition, n = 1). There were no significant differences with respect to the means of the changes in all the scales. The results of the present study indicate that aripiprazole does not have adequate efficacy for the treatment of BPSD and are in line with those in the current literature [4]. The disinhibition that was twice observed as a side-effect of the aripiprazole treatment involved a patient grabbing food off another patient's plate. One of the signs of efficacy involves reactivation, but aripiprazole may cause inappropriate reactivation as shown by the food-stealing incident.