J Mintzer1, W Faison, J S Street, V K Sutton, A Breier. 1. Medical University of South Carolina, Alzheimer's Research and Clinical Programs Charleston, SC 29406-6076, USA. mintzerj@musc.edu
Abstract
BACKGROUND:Alzheimer's disease (AD) is associated with both cognitive and behavioral symptoms. Agitation, hallucinations, delusions, aggression, irritability, and anxiety are observed in up to 90% of patients with dementia. Although new information has emerged in recent years on the treatment of psychosis and agitation in dementia, very little information is available about the treatment of anxiety symptoms in this population. OBJECTIVES: To assess the efficacy and tolerability of olanzapine in the treatment of significant anxiety symptoms in patients with AD. METHODS: A post hoc analysis of a previously published study was performed. Those post hoc analysis evaluated the response to treatment with olanzapine of a subgroup of AD patients presenting with significant symptoms of anxiety. Patients were considered to have significant symptoms of anxiety if their baseline in the Nursing home version of the Neuropsychiatric Instrument NPI/NH anxiety scores were > or = 2. The analysis included 120 patients. RESULTS: Patients receiving olanzapine 5 mg/d were statistically significantly improved on the NPI/NH Anxiety item compared to those receiving placebo (olanzapine, 5 mg/d: -3.72; placebo: -1.67; p = 0.034). In the group of patients with clinically significant anxiety, somnolence was the only treatment-emergent event that was statistically different in any olanzapine treatment group compared with placebo (olanzapine 5 mg/d: 9 patients [25%], p = 0.034; 10 mg/d: 7 [23%], p = 0.054; 15 mg/d: 7 [26%], p = 0.050; placebo: 1 [3.7%]). When controlling for treatment-emergent somnolence, the improvement in anxiety in the olanzapine 5 mg/d group remained statistically significant (p = 0.049). CONCLUSIONS: These findings suggest that olanzapine could be a safe and effective treatment for anxiety in Alzheimer's disease. Copyright 2001 John Wiley & Sons, Ltd.
RCT Entities:
BACKGROUND:Alzheimer's disease (AD) is associated with both cognitive and behavioral symptoms. Agitation, hallucinations, delusions, aggression, irritability, and anxiety are observed in up to 90% of patients with dementia. Although new information has emerged in recent years on the treatment of psychosis and agitation in dementia, very little information is available about the treatment of anxiety symptoms in this population. OBJECTIVES: To assess the efficacy and tolerability of olanzapine in the treatment of significant anxiety symptoms in patients with AD. METHODS: A post hoc analysis of a previously published study was performed. Those post hoc analysis evaluated the response to treatment with olanzapine of a subgroup of ADpatients presenting with significant symptoms of anxiety. Patients were considered to have significant symptoms of anxiety if their baseline in the Nursing home version of the Neuropsychiatric Instrument NPI/NH anxiety scores were > or = 2. The analysis included 120 patients. RESULTS:Patients receiving olanzapine 5 mg/d were statistically significantly improved on the NPI/NH Anxiety item compared to those receiving placebo (olanzapine, 5 mg/d: -3.72; placebo: -1.67; p = 0.034). In the group of patients with clinically significant anxiety, somnolence was the only treatment-emergent event that was statistically different in any olanzapine treatment group compared with placebo (olanzapine 5 mg/d: 9 patients [25%], p = 0.034; 10 mg/d: 7 [23%], p = 0.054; 15 mg/d: 7 [26%], p = 0.050; placebo: 1 [3.7%]). When controlling for treatment-emergent somnolence, the improvement in anxiety in the olanzapine 5 mg/d group remained statistically significant (p = 0.049). CONCLUSIONS: These findings suggest that olanzapine could be a safe and effective treatment for anxiety in Alzheimer's disease. Copyright 2001 John Wiley & Sons, Ltd.
Authors: Jing Liang; Héctor E López-Valdés; Hilda Martínez-Coria; A Kerstin Lindemeyer; Yi Shen; Xuesi M Shao; Richard W Olsen Journal: Neurochem Res Date: 2014-04-13 Impact factor: 3.996
Authors: Melinda A Stanley; Jessica Calleo; Amber L Bush; Nancy Wilson; A Lynn Snow; Cynthia Kraus-Schuman; Amber L Paukert; Nancy J Petersen; Gretchen A Brenes; Paul E Schulz; Susan P Williams; Mark E Kunik Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105