The AGIT-AD trial – alternative treatments in the management of agitation in people with dementia
Ed Juszczak with Clive Ballard (Newcastle)
People with dementia frequently experience intrusive neuropsychiatric symptoms. These are distressing, present major difficulties for caregivers and accelerate nursing home placement. Neuroleptic drugs are frequently prescribed to as many as 45% of people with dementia in residential or nursing homes, often for prolonged periods. Neuroleptics have modest efficacy but are commonly associated with substantial adverse effects. More seriously, an increased risk of stroke in dementia patients taking the two most widely prescribed atypical antipsychotics, risperidone and olanzapine, has become evident. Unfortunately there are no published randomised controlled trials for other atypical antipsychotics in people with dementia.
AGIT-AD was a double-blind, three arm, placebo-controlled, parallel group randomised controlled trial investigating the efficacy and tolerability of a cholinesterase inhibitor (rivastigmine) and an atypical neuroleptic (quetiapine), respectively, in the management of agitation in people with dementia. 93 participants with Alzheimer’s disease (AD), dementia and clinically significant agitation, resident in care facilities in the North East of England were randomised to quetiapine, rivastigmine or placebo. The main outcome measures were the Cohen-Mansfield Agitation Inventory (agitation), and the Severe Impairment Battery (cognition), assessed at baseline, 6 weeks and 26 weeks follow-up.
Publication: 181
