Efficacy and Tolerability of Carbamazepine for Agitation and Aggression in Dementia
Abstract
Objective The efficacy, safety, and tolerability of carbamazepine in the treatment of agitation and aggression associated with dementia were assessed. Method In a 6-week, randomized, multisite, parallel-group study of 51 nursing home patients with agitation and dementia, individualized doses of carbamazepine were compared with placebo. Except for a physician monitor and a pharmacist, all participants were blind to treatment. The primary outcome measures were the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) global improvement rating. Secondary measures included measures of behavior, aggression, cognition, functional status, staff time, safety, and tolerability. Intent-to-treat analysis was performed. Results The modal carbamazepine dose at 6 weeks was 300 mg/day, and a mean serum level of 5.3 micrograms/ml was achieved. The study was terminated after a planned interim analysis showed that carbamazepine provided more benefit than did placebo. Over 6 weeks the mean total BPRS score decreased 7.7 points for the carbamazepine group and 0.9 for the placebo group, and the weekly scores showed a gradual divergence between the two groups. CGI ratings showed global improvement in 77% of the patients taking carbamazepine and 21% of those taking placebo. Secondary analyses confirmed that the positive changes were due to decreased agitation and aggression. The drug was generally well tolerated, and no change in cognition or functional status occurred. The per…
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Two small trials of carbamazepine (n=51 and n=21) of less than six weeks' duration showed some benefit for agitation and global clinical outcomes.
“Two small trials of carbamazepine (n=51 and n=21) of less than six weeks’ duration showed some benefit for agitation and global clinical outcomes.143 144”
From Assessment and management of behavioral and psychological symptoms of dementia (2015) · cites this paper as [143]
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- Authors
- Tariot, P. N., Erb, R., Podgorski, C. A., Cox, C., Patel, S., Jakimovich, L., & Irvine, C.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- American Journal of Psychiatry
- Published
- 1998-01-01
- Volume
- 155
- Issue
- 1
- Pages
- 54-61
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2140320787
- Semantic Scholar
- c3da70c064f129607116262314bf832944063d1a
- Cited by
- 422
- References
- 27
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 8 · 2023: 3 · 2022: 38 · 2021: 10 · 2020: 8 · 2019: 12 · 2018: 14 · 2017: 14 · 2016: 8 · 2015: 8 · 2014: 12 · 2013: 10 · 2012: 12
- FWCI
- 13.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 08665, AG-10463, P60AG010463, P30AG008665)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- carbamazepine, dementia, agitation, aggression, nursing home residents, antipsychotic efficacy, drug tolerability, safety, Brief Psychiatric Rating Scale, Clinical Global Impression Scale, staff time, individualized dosing
- MeSH terms
- Aged, Aged, 80 and over, Aggression, Alzheimer Disease, Carbamazepine, Dementia, Drug Administration Schedule, Female, Humans, Male, Nursing Homes, Placebos, Psychiatric Status Rating Scales, Psychomotor Agitation, Dementia, Vascular, Treatment Outcome
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