Antipsychotics in the Management of Behavioral and Psychological Symptoms of Dementia: Maximizing Gain and Minimizing Harm

Abstract

Zhai et al., in their meta-analysis which included data from 12 studies, found that the pooled relative risk of death among individuals with dementia was 1.36 (95% CI: 0.83-2.24) among antipsychotic drugs users versus nonusers (10). A meta-analysis by Rao et al., which evaluated data from population-based studies, found that the risk of CVA among individuals with dementia who were prescribed atypical antipsychotics was 1.61% when compared with 1.06% among individuals prescribed typical antipsychotics (relative risk=1.02; p = 0.96) (12). In a meta-analysis by Wolf et al., which included data from ten studies, the authors found that there was no significant effect on cognition with the use of antipsychotics among individuals with dementia (SMD=-0.065), but they noted a substantial correlation between cognitive impairment and treatment duration (p < 0.02) and also baseline cognition as measured by the Mini Mental State Examination (p < 0.005) (13). ...]they used the difference between groups in the number of noncompleters of the study as a proxy for the primary outcome.