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Clinical management of agitation in the elderly with tiapride

Published online by Cambridge University Press:  16 April 2020

P.H. Robert  and
H. Allain
P.H. Robert*
Affiliation:
Memory Centre, Psychiatric Clinic, CHU Nice, France
H. Allain
Affiliation:
Laboratory of Clinical Pharmacology, CHU Rennes, France
*
Correspondence and reprints: Pr P.H. Robert, Hôpital Pasteur, Pavillon J, 30, avenue de la Voie Romaine, 06002 Nice cedex 1, France. E-mail address: [email protected] (P.H. Robert).
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Summary

Agitated behaviors such as uncooperativeness with necessary care, motor hyperactivity, and verbal or physical aggression are some of the most commonly reported complications in dementia and organic disorders in elderly subjects. These symptoms present greater clinical challenges and management issues than the cognitive deficits. Antipsychotics are the most commonly used psychotropic agents for treating these types of symptoms.

The aims of this article are to review clinical studies with tiapride, a substituted benzamide, and more specifically to present recent data coming from two double-blind, randomized studies in elderly subjects.

The first study versus melperone was conducted in Germany, with over 176 hospitalized demented patients, and indicated that tiapride was as effective and safe as melperone.

More recently, a multicentre, international, double-blind, three-parallel group study compared a 21-day treatment of tiapride to haloperidol and placebo and included 306 demented elderly patients with agitation and aggressiveness. The results showed that tiapride and haloperidol were significantly effective in the treatment of agitation and aggressiveness compared to placebo. The tiapride safety profile was found to be better than haloperidol for clinical acceptability, particularly for significantly fewer extrapyramidal symptoms in the tiapride group.

Keywords

aggressionagitationantipsychoticsdementiaelderlytiapride
Type
Original article
Information
European Psychiatry , Volume 16 , Issue S1 , 2001 , pp. 42s - 47S
Copyright
Copyright © 2001 Éditions scientifiques et médicales Elsevier SAS. All rights reserved

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References

Allain, H, Dautzenberg, PHJ, Maurer, K, Schuck, S, Bonhomme, D, Gérard, D.Double-blind study of tiapride versus haloperidol and placebo in agitation and aggresiveness in elderly patients with cognitive impairment. Psychopharmacology 2000; 48: 361–6.CrossRefGoogle Scholar
American Psychiatry Association. Practice guidelines for the treatment of patients with Alzheimer’s disease and other dementia of late life. Am J Psychiatry 1997; X Suppl: 154–5.Google Scholar
Cohen-Mansfield, JAgitation in the elderly. Bilig, N, Rabins, P, Eds.; Advances in psychosomatic medicine geriatric psychiatry. Basel: Karger; 1989. 101–13.Google Scholar
Finkel, SI, Costa e Silva, J, Cohen, G, Miller, S, Sartorius, N.Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr 1996; 8: 497–500.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR.“Mini-mental test”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 1975; 12: 189–98.CrossRefGoogle Scholar
Gulzmann, H, Kuhl, KP, Kanowski, S, Khan-Boluki, J.Measuring the efficacy of psychopharmacological treatment of psychomotoric restlessness in dementia: clinical evaluation of tiapride. Pharmacopsychiatry 1997; 30: 6–11.CrossRefGoogle Scholar
Hehnes, E.Multidimensional observation scalefor elderly subjects. Psychopharmacol Bull 1988; 24 suppl: 733–45.Google Scholar
Jeste, DV, Caliguiri, MP, Paulsen, JS, Heaton, RK, Lacro, JP, Harris, M. et al. Risk of tardive dyskinesia in older patients: a prospective longitudinal study of 266 outpatients. Arch Gen Psychiatry 1995; 52: 756–65.CrossRefGoogle ScholarPubMed
Lingjaerd, O, Ahlfors, WG, Bech, P, Dencker, ST, Elgen, K.The UKU side-effect rating scale. Acta Psychiatr Scand 1987; 76: 85–94.Google Scholar
McShane, R, Keene, J, Gedling, K, Fairburn, C, Jacoby, R, Hope, T.Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow-up. Br Med J 1997; 70: 266–314.CrossRefGoogle Scholar
Mortimer, JA, Ebbitt, B.Predictors of cognitive and functional progression in patients with probable Alzheimer’s disease. Neurology 1992; 42: 1689–96.CrossRefGoogle ScholarPubMed
National Institute of Mental Health. Clinical global impressions. Guy, W, Bonato, RR, Eds.; ECDEU assessment for psychopharmacology. Maryland: Rev Ed Rockville; 1976. 218–222.Google Scholar
Othorno, E, Urasawa, K, Tohgi, H.Clinical usefulness of tiapride in the treatinent of psychiatric symptoms treated by cerebral infraction. Rinsho Igaku 1989; 5: 1243–71.Google Scholar
Roger, M, Gerard, D, Leger, JM.Intérêt du tiapride dans les états d’agitation du sujet âgé. Revue des études publiées. L'Encéphale 1998; XXIV: 462–8.Google Scholar
Schneider, LS, Pollock, VE, Lyness, SA.A meta-analysis of controlled trials of neuroleptic treatment in dementia. J Am Geriatr Soc 1990; 38: 553–63.CrossRefGoogle ScholarPubMed
Shimizu, M, Hasegawa, K, Nishimura, T, Miyasaka, M, Ishino, H, Yamada, M.Comparison of the clinical effects of tiapride, sulpiride and chlorpromazine in elderly patients with organic psychosis using a multi-center double-blind technique. Jpn J Clin Psychiatry 1984; 13: 1017–31.Google Scholar
Shimizu, M, Hasegawa, K, Nishimura, T, Miyasaka, M, Ishino, H, Yarnada, M.A double-blind study of tiapride with chlorpromazine in patients with psychiatric disorders of the aged in a mutli-center trial. Psychiatr M 1985; 27: 573–84.Google Scholar
Teri, L, Hughes, JP, Larson, EB.Cognitive deterioration in Alzheimer’s disease: behavioral and health factors. J Gerontol 1990; 45: 58–63.CrossRefGoogle ScholarPubMed
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