POSSIBLE ALTERNATIVE TO PSYCHOTROPIC DRUGS FOR BEHAVIOR CONTROL

A recent article published on Dementia & Alzheimer’s Weekly (http://alzheimersweekly.com) caught my attention because it talks about a small study conducted by Dr. Bruce Pollock of the University of Toronto’s Department of Psychiatry.  The study assigned 103 hospitalized patients at the University of Pittsburgh Medical Center into either the group receiving risperidone (Risperidal), or the group receiving the anti-depressant citalopram (Celexa) for their psychiatric disturbances such as delusions, suspicious thoughts, and visual hallucinations.  They found, after 12 weeks, a 32% reduction in symptoms among patients receiving the citalopram, compared to a 35% reduction for those receiving risperidone.   But, more importantly, they also found a 19% INCREASE in side effects with the risperidone use, compared to a 4% decrease for those taking the citalopram.  (These findings were published in the 9/10/12 online edition of the American Journal of Geriatric Psychiatry).  Since a huge majority of elders with dementia will suffer these symptoms while hospitalized, it’s a promising avenue for researchers to explore to help reduce not only the symptoms, but the inability of family members to continue to care for their loved ones, and thus, admitting them into higher levels of care.  This is certainly not an easy answer to the behaviors of elders with dementia in hospital settings, but it does beg for more study.  The article notes citalopram should be compared to placebo, and I would add that it should also be determined first whether or not these elders are actually delirious during these behaviors as it’s not always easy to differentiate out if the behaviors are a result of the dementia, or a delirium which can be treated and which will resolve.

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