Evidence map›Paper›PMID 29637593›Full record

SynthesisBritish journal of clinical pharmacology2018

Pharmacological treatments for alleviating agitation in dementia: a systematic review and network meta-analysis.

Khachen Kongpakwattana, Ratree Sawangjit, Itthipol Tawankanjanachot, J Simon Bell, Sarah N Hilmer, Nathorn Chaiyakunapruk

Open access · bronzeAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 63 citations in OpenAlex.

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  8. Antidepressant Use Among US Nursing Home Residents With Dementia.Journal of the American Geriatrics Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 4 countries.

Khachen KongpakwattanaSchool of Pharmacy, Monash University Malaysia, Selangor, Malaysia.
Ratree SawangjitClinical Trials and Evidence Base Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.ORCID 0000-0002-6868-4336
Itthipol TawankanjanachotDepartment of Psychiatry, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Australia.
Sarah N HilmerKolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, St Leonards, NSW, Australia.ORCID 0000-0002-5970-1501
Nathorn ChaiyakunaprukSchool of Pharmacy, Monash University Malaysia, Selangor, Malaysia.ORCID 0000-0001-6213-722X
Monash University Malaysia · MYChulalongkorn University · THMahasarakham University · THMonash University · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo determine the most efficacious and acceptable treatments of agitation in dementia.

methodsMEDLINE, EMBASE, PsycINFO, CENTRAL and clinicaltrials.gov were searched up to 7 February 2017. Two independent reviewers selected randomized controlled trials (RCTs) of treatments to alleviate agitation in people with all-types dementia. Data were extracted using standardized forms and study quality was assessed using the revised Cochrane Risk of Bias Tool for RCTs. Data were pooled using meta-analysis. The primary outcome, efficacy, was 8-week response rates defined as a 50% reduction in baseline agitation score. The secondary outcome was treatment acceptability defined as treatment continuation for 8 weeks.

resultsThirty-six RCTs comprising 5585 participants (30.9% male; mean ± standard deviation age, 81.8 ± 4.9 years) were included. Dextromethorphan/quinidine [odds ratio (OR) 3.04; 95% confidence interval (CI), 1.63-5.66], risperidone (OR 1.96; 95% CI, 1.49-2.59) and selective serotonin reuptake inhibitors as a class (OR 1.61; 95% CI, 1.02-2.53) were found to be significantly more efficacious than placebo. Haloperidol appeared less efficacious than nearly all comparators. Most treatments had noninferior treatment continuation compared to placebo, except oxcarbazepine, which was inferior. Findings were supported by subgroup and sensitivity analyses.

conclusionsRisperidone, serotonin reuptake inhibitors as a class and dextromethorphan/quinidine demonstrated evidence of efficacy for agitation in dementia, although findings for dextromethorphan/quinidine were based on a single RCT. Our findings do not support prescribing haloperidol due to lack of efficacy, or oxcarbazepine due to lack of acceptability. The decision to prescribe should be based on comprehensive consideration of the benefits and risks, including those not evaluated in this meta-analysis.

Indexed as

Antipsychotic AgentsDementiaDextromethorphanDrug CombinationsHumansPsychometricsPsychomotor AgitationQuinidineRandomized Controlled Trials as TopicRisperidoneSelective Serotonin Reuptake InhibitorsSeverity of Illness IndexTreatment OutcomeAntipsychotic AgentsDextromethorphandextromethorphan - quinidine combinationDrug CombinationsQuinidineRisperidoneSelective Serotonin Reuptake InhibitorsagitationAlzheimer's diseasedementianetwork meta-analysispharmacological treatments

Identifiers

PMID29637593
PMCPMC6005613
OpenAlexW2797159220

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.