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Anticonvulsants for the treatment of behavioral and psychological symptoms of dementia: a literature review

Published online by Cambridge University Press:  30 November 2007

Sergiy Konovalov ,
Sunanda Muralee  and
Rajesh R. Tampi
Sergiy Konovalov
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
Sunanda Muralee
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
Rajesh R. Tampi*
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
*
Correspondence should be addressed to: Dr. Rajesh R. Tampi, Director, Geriatric Psychiatry Fellowship Program, Yale University School of Medicine, LV-121 Yale New Haven Psychiatric Hospital, 184 Liberty Street, New Haven, CT 06519, U.S.A. Phone: +1 203 688 9893; Fax: +1 203 688 9709. Email: [email protected].
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Abstract

Objective: To review and summarize the currently available data on the use of anticonvulsant mood stabilizers (carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate) in the treatment of behavioral and psychological symptoms of dementia (BPSD); to determine whether these medications can be recommended for routine clinical use.

Methods: Literature search in five databases (PubMed, MEDLINE, EMBASE, PsychINFO and COCHRANE collaboration) and analysis of the randomized controlled double-blinded clinical trials found therein.

Results: A total of seven RCTs were identified (two for carbamazepine and five for valproate). One study showed statistically significant improvement of BPSD in the medication group in comparison to the placebo group; five studies showed no significant differences; one study showed statistically significant worsening of the symptoms in the medication group vs. placebo. The majority of the studies reported significantly more frequent adverse effects in the medication group.

Conclusion: Although clearly beneficial in some patients, anticonvulsant mood stabilizers cannot be recommended for routine use in the treatment of BPSD at the present time.

Keywords

neuropsychiatric symptoms of dementiamood stabilizersdivalproex sodiumcarbamazepinegabapentinlamotriginetopiramate
Type
REVIEW
Information
International Psychogeriatrics , Volume 20 , Issue 2 , April 2008 , pp. 293 - 308
Copyright
Copyright © International Psychogeriatric Association 2007

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