ArticleAlzheimer's research & therapy2015
Efficacy and safety of atypical antipsychotic drug treatment for dementia: a systematic review and meta-analysis.
Article in Alzheimer's research & therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Run-in periods and clinical outcomes of antipsychotics in dementia: A meta-epidemiological study of placebo-controlled trials.Pharmacoepidemiology and drug safety · 2020Pooled it
- The treatment of cognitive dysfunction in dementia: a multiple treatments meta-analysis.Psychopharmacology · 2018Pooled it
- Article
- Subjective Versus Objective Outcomes of Antipsychotics for the Treatment of Neuropsychiatric Symptoms Associated with Dementia.CNS drugs · 2019Article
- Perceptions vs. evidence: therapeutic substitutes for antipsychotics in patients with dementia in long-term care.Aging & mental health · 2018Article
- Treatment of behavioral and psychological symptoms of dementias with psychopharmaceuticals: a review.Neuropsychiatric disease and treatment · 2018Review
- Dual Health Care System Use and High-Risk Prescribing in Patients With Dementia: A National Cohort Study.Annals of internal medicine · 2017Observational
- Person-Centered Primary Care Strategies for Assessment of and Intervention for Aggressive Behaviors in Dementia.Journal of gerontological nursing · 2017Article
- A review on mortality risks associated with antipsychotic use in behavioral and psychologic symptoms of dementia (BPSD).The mental health clinician · 2016Article
- Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses.Therapeutic advances in chronic disease · 2016Article
- Improvements in the prescribing of antipsychotics in dementia and psychogeriatric units in New Zealand.International journal of clinical pharmacy · 2016Article
- Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies.Nature and science of sleep · 2016Review
Corrections and comments
- Retraction · 2016-06-13Error in Data · Error in Methods ·
- Retracted
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA wide variety of atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone and clozapine) are widely used in the management of neuropsychiatric symptoms, which are commonly seen in dementia, but results from randomised controlled trials (RCTs) on the efficacy and safety of these agents are conflicting. We aimed to quantify the efficacy and safety of atypical antipsychotic drugs on neuropsychiatric symptoms in dementia patients.
methodsPubMed, EMBASE, the Cochrane Controlled Trials Register and the Cochrane Database of Systematic Reviews for reports published before August 2014 were searched for eligible randomized controlled trials of atypical antipsychotic drugs therapy in patients with psychotic symptoms of dementia. Two reviewers independently assessed the quality of the trials and extracted information.
resultsOverall, 23 relevant RCTs with 5,819 participants were identified. This meta-analysis demonstrated a significant efficacy of atypical antipsychotics on psychiatric symptoms and cognitive functions compared to placebo. In the meta-analysis, the weighted mean differences (WMDs) in change scores for psychiatric symptoms were in favor of aripiprazole (-4.4, 95% confidence interval (CI) - 7.04 to -1.77) and risperidone (-1.48, 95% CI -2.35 to -0.61) compared to placebo. In cognitive effects, WMDs in change scores for the Clinical Global Impression-Change (CGI-C) were in favor of aripiprazole, risperidone, olanzapine and quetiapine which ranged from a -0.30 points mean difference (95% CI:-0.59 to -0.01) in the aripiprazole trials to -0.43 (95% CI:-0.62 to -0.25) in the risperidone group. Patients receiving atypical antipsychotics showed no difference in risk for injuries or falls (P > 0.05), significantly higher risks (P < 0.05) for somnolence, urinary tract infection, edema and abnormal gait. However, there was no significant evidence for death reported.
conclusionAripiprazole and risperidone are able to improve psychiatric symptoms and slow decline in cognition function at average 12 weeks in patients with neuropsychiatric symptoms of dementia. However, high adverse events may offset the efficacy of atypical antipsychotics in dementia.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.