Evidence map›Paper›PMID 33685912›Full record

ArticleBMJ case reports2021

Treatment with the direct oral anticoagulants (DOACs) apixaban and rivaroxaban associated with significant worsening of behavioural and psychological symptoms of dementia (BPSD).

Kim Maria Frances Porter, Iain Parry Hargreaves, Stephen De Souza, Rebecca Goddard

Open access · hybridAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
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

4 authors at 4 institutions in 1 country.

Kim Maria Frances PorterOlder Peoples Community Mental Health Team, Somerset NHS Foundation Trust, Frome, Somerset, UK.
Iain Parry HargreavesDepartment of Molecular Neuroscience, UCL Queen Square Institute of Neurology, National Hospital, London, UK i.hargreaves@ucl.ac.uk.
Stephen De SouzaOlder Peoples Psychiatric Inpatient Unit, Somerset NHS Foundation Trust, Taunton, Somerset, UK.
Rebecca GoddardComplex Treatment and Intervention Team, Avon and Wiltshire Mental Health Partnership NHS Trust, Midsomer Norton, Somerset, UK.
Avon and Wiltshire Mental Health Partnership NHS Trust · GBSomerset Partnership NHS Foundation Trust · GBTaunton & Somerset NHS Foundation Trust · GBUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report the cases of two patients who developed worsening behavioural and psychological symptoms of dementia (BPSD), coinciding with starting the factor Xa inhibitor direct oral anticoagulant medications apixaban and rivaroxaban, respectively. Both patients required detaining under the Mental Health Act. Their symptoms improved significantly, within 2 weeks, on switching to alternative anticoagulant therapies and they were both discharged from the acute psychiatric ward. Front-line staff should partake in postmarketing surveillance of medications, completing the Medicines and Healthcare products Regulatory Agency yellow cards for example (UK). There is increasing evidence for an aetiological role of cerebral mitochondrial dysfunction in neuropsychiatric disorders. Development of a rating scale of drugs that are potentially less toxic to cerebral mitochondria could inform national prescribing guidelines and enable safer treatments to be offered to older people, reducing the likely hood of them experiencing apparent BPSD.

Indexed as

DementiaRivaroxabanAdministration, OralAgedAged, 80 and overAnticoagulantsDabigatranHumansPyrazolesPyridonesAnticoagulantsapixabanDabigatranPyrazolesPyridonesRivaroxabandrugs: CNS (not psychiatric)memory disorders (psychiatry)psychiatry (drugs and medicines)psychiatry of old ageunwanted effects / adverse reactions

Identifiers

PMID33685912
PMCPMC7942237
OpenAlexW3133790151

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.