Efficacy of antipsychotics in dementia depended on the definition of patients and outcomes: a meta-epidemiological study

Journal of Clinical Epidemiology
C H W SmeetsH J Luijendijk

Abstract

Postulating that efficacy of antipsychotics for agitation and psychosis in dementia is best estimated in trials among patients with these symptoms and with symptom-specific outcomes, we investigated whether clinically broader definitions affected the pooled efficacy. Trials were searched in multiple databases and categorized according to patient population (agitated, psychotic, and mixed) and outcome scale (agitation, psychosis, and generic). Standardized mean differences with 95% confidence intervals were calculated for conventional and atypical antipsychotics separately. Thirty trials met our inclusion criteria. Conventional antipsychotics might have a small effect in agitated patients on agitation scales (-0.44, -0.88, 0.01) and in psychotic patients on psychosis scales (-0.31, -0.61, -0.02). There was no effect on generic scales. Efficacy of atypical antipsychotics was not established in agitated patients on agitation scales (-0.15, -0.43, 0.13) and in psychotic patients on psychosis scales (-0.11, -0.20, -0.03) but was small in mixed patients on agitation scales (-0.29, -0.40, -0.18). Pooled efficacy of antipsychotics for agitation and psychosis in dementia is biased when based on trials that included patients without thes...Continue Reading

Citations

Feb 7, 2020·Neurodegenerative Disease Management·Rajesh R TampiSuganthi Alagarsamy
Mar 17, 2020·Annals of Internal Medicine·Calvin Hirsch
Mar 11, 2020·Frontiers in Pharmacology·Tessa A HulshofHendrika J Luijendijk
Dec 18, 2021·The Cochrane Database of Systematic Reviews·Viktoria MühlbauerHendrika J Luijendijk

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