http://archpsyc.jamanetwork.com/ en-us Mon, 10 Dec 2012 00:00:00 GMT Tue, 01 Jan 2013 00:49:40 GMT Silverchair editor@archpsyc.jamanetwork.com webmaster@archpsyc.jamanetwork.com http://archpsyc.jamanetwork.com/article.aspx?articleID=481661 Sun, 01 Oct 2000 00:00:00 GMT Street JS, Clark W, Gannon KS, et al. <span class="paragraphSection"><div class="boxTitle">Background</div>Patients with Alzheimer disease (AD) commonly exhibit psychosis and behavioral disturbances that impair patient functioning, create caregiver distress, and lead to institutionalization. This study was conducted to assess the efficacy and safety of olanzapine in treating psychosis and/or agitation/aggression in patients with AD.<div class="boxTitle">Methods</div>A multicenter, double-blind, placebo-controlled, 6-week study was conducted in 206 elderly US nursing home residents with AD who exhibited psychotic and/or behavioral symptoms. Patients were randomly assigned to placebo or a fixed dose of 5, 10, or 15 mg/d of olanzapine. The primary efficacy measure was the sum of the Agitation/Aggression, Hallucinations, and Delusions items (Core Total) of the Neuropsychiatric Inventory–Nursing Home version.<div class="boxTitle">Results</div>Low-dose olanzapine (5 and 10 mg/d) produced significant improvement compared with placebo on the Core Total (−7.6 vs −3.7 [<span style="font-style:italic;">P</span><.001] and −6.1 vs −3.7 [<span style="font-style:italic;">P</span> = .006], respectively). Core Total improvement with olanzapine, 15 mg/d, was not significantly greater than placebo. The Occupational Disruptiveness score, reflecting the impact of patients' psychosis and behavioral disturbances on the caregiver, was significantly reduced in the 5-mg/d olanzapine group compared with placebo (−2.7 vs −1.5; <span style="font-style:italic;">P</span> = .008). Somnolence was significantly more common among patients receiving olanzapine (25.0%-35.8%), and gait disturbance occurred in those receiving 5 or 15 mg/d (19.6% and 17.0%, respectively). No significant cognitive impairment, increase in extrapyramidal symptoms, or central anticholinergic effects were found at any olanzapine dose relative to placebo.<div class="boxTitle">Conclusion</div>Low-dose olanzapine (5 and 10 mg/d) was significantly superior to placebo and well tolerated in treating agitation/aggression and psychosis in this population of patients with AD.</span> 57 10 968 976 10.1001/archpsyc.57.10.968 http://archpsyc.jamanetwork.com/article.aspx?articleID=481661