Please use this identifier to cite or link to this item: https://cuir.car.chula.ac.th/handle/123456789/62127
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dc.contributor.authorItthipol Tawankanjanachot-
dc.contributor.authorChulalongkorn University. Faculty of Medicine-
dc.date.accessioned2019-06-17T07:30:16Z-
dc.date.available2019-06-17T07:30:16Z-
dc.date.issued2018-04-10-
dc.identifier.citationBritish Journal of Clinical Pharmacology. Vol.84, Article No.7 (2018), p.1445-1456en_US
dc.identifier.issn0306-5251-
dc.identifier.urihttp://cuir.car.chula.ac.th/handle/123456789/62127-
dc.description.abstractAims : To determine the most efficacious and acceptable treatments of agitation in dementia. Methods : MEDLINE, EMBASE, PsycINFO, CENTRAL and clinicaltrials.gov were searched up to 7 February 2017. Two independent reviewers selected randomized controlled trials (RCTs) of treatments to alleviate agitation in people with all‐types dementia. Data were extracted using standardized forms and study quality was assessed using the revised Cochrane Risk of Bias Tool for RCTs. Data were pooled using meta‐analysis. The primary outcome, efficacy, was 8‐week response rates defined as a 50% reduction in baseline agitation score. The secondary outcome was treatment acceptability defined as treatment continuation for 8 weeks. Results : Thirty‐six RCTs comprising 5585 participants (30.9% male; mean ± standard deviation age, 81.8 ± 4.9 years) were included. Dextromethorphan/quinidine [odds ratio (OR) 3.04; 95% confidence interval (CI), 1.63–5.66], risperidone (OR 1.96; 95% CI, 1.49–2.59) and selective serotonin reuptake inhibitors as a class (OR 1.61; 95% CI, 1.02–2.53) were found to be significantly more efficacious than placebo. Haloperidol appeared less efficacious than nearly all comparators. Most treatments had noninferior treatment continuation compared to placebo, except oxcarbazepine, which was inferior. Findings were supported by subgroup and sensitivity analyses. Conclusions : Risperidone, serotonin reuptake inhibitors as a class and dextromethorphan/quinidine demonstrated evidence of efficacy for agitation in dementia, although findings for dextromethorphan/quinidine were based on a single RCT. Our findings do not support prescribing haloperidol due to lack of efficacy, or oxcarbazepine due to lack of acceptability. The decision to prescribe should be based on comprehensive consideration of the benefits and risks, including those not evaluated in this meta‐analysis.en_US
dc.language.isoenen_US
dc.publisherBlackwell Publishingen_US
dc.relation.urihttps://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.13604-
dc.relation.urihttps://doi.org/10.1111/bcp.13604-
dc.rights© 2018 The British Pharmacological Societyen_US
dc.titlePharmacological treatments for alleviating agitation in dementia: a systematic review and network meta‐analysisen_US
dc.typeArticleen_US
dc.email.authorNo information provided-
dc.subject.keywordagitationen_US
dc.subject.keywordAlzheimer's diseaseen_US
dc.subject.keyworddementiaen_US
dc.subject.keywordnetwork meta‐analysisen_US
dc.subject.keywordpharmacological treatmentsen_US
dc.identifier.DOI10.1111/bcp.13604-
Appears in Collections:Foreign Journal Article

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